Healthcare Provider Details

I. General information

NPI: 1578658647
Provider Name (Legal Business Name): COMMUNITY CORNERSTONES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URBANIZACION SANTA MARIA SHOPPING CENTER OFICINA 234 COMMUNITY CORNERSTONES, INC.
PONCE PR
00731-0000
US

IV. Provider business mailing address

1549 CALLE ALDA URBANIZACION CARIBE
SAN JUAN PR
00926-2709
US

V. Phone/Fax

Practice location:
  • Phone: 787-651-0030
  • Fax: 787-651-0033
Mailing address:
  • Phone: 787-622-9797
  • Fax: 787-622-9888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SARA LAFITA
Title or Position: DIRECTOR OF AMBULATORY SERVICES
Credential: RN MSN
Phone: 787-622-9797