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General NPI Number Information
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NPI Number | 1053786020
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Entity Type | Organization
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Legal Business Name | CORNNERSTONE CENTER FOR RESEARCH & DEVELOPMENT
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 1517 REISTERSTOWN RD STE 218
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City | PIKESVILLE
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State | MD
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Zip | 21208-4325
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Country | US
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Telephone | 410-415-1983
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Fax | 180-080-6312
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Provider Business Mailing Address
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Address Line | 1517 REISTERSTOWN ROAD SUITE 218
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City | REISTERSTOWN
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State | MD
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Zip | 21208
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Country | US
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Telephone | 410-415-1983
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Fax | 180-080-6312
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Authorized Official
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Title or Position | CHIEF EXECUTIVE
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Name | MR. REGINALD UCHENNA AMADI
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Credential | RN
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Telephone | 443-985-5795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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