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General NPI Number Information
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NPI Number | 1194619924
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Entity Type | Organization
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Legal Business Name | CORNERSTONE INNOVATIONS HEALTHCARE LLC
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 740 THIMBLE SHOALS BLVD STE D
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-3574
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Country | US
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Telephone | 910-264-5045
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Fax | 757-705-8330
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Provider Business Mailing Address
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Address Line | 740 THIMBLE SHOALS BLVD STE D
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-3574
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Country | US
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Telephone | 910-264-5045
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Fax | 757-705-8330
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Authorized Official
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Title or Position | CEO
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Name | TAMEKA DAVIS
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Credential |
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Telephone | 910-264-5045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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