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General NPI Number Information
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NPI Number | 1124038690
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Entity Type | Organization
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Legal Business Name | CORNERSTONE GARDENS L L P
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 763 MARLANDWOOD RD
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City | TEMPLE
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State | TX
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Zip | 76502-3573
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Country | US
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Telephone | 254-771-5950
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Fax |
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Provider Business Mailing Address
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Address Line | 7150 GANTT ACCESS RD
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City | AZLE
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State | TX
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Zip | 76020-5638
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Country | US
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Telephone | 817-444-2516
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Fax |
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | MAURA PANOS
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Credential |
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Telephone | 817-444-2516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 125282
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License Number State | TX
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