Healthcare Provider Details

I. General information

NPI: 1013543602
Provider Name (Legal Business Name): CORNERSTONE CARE OF NEW ENGLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 HARTFORD AVE
WILDER VT
05088
US

IV. Provider business mailing address

PO BOX 943
WILDER VT
05088-0943
US

V. Phone/Fax

Practice location:
  • Phone: 603-252-0510
  • Fax:
Mailing address:
  • Phone: 802-595-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DANELLE HOLLYER
Title or Position: CO OWNER
Credential:
Phone: 802-595-2666