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General NPI Number Information
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NPI Number | 1255681805
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Entity Type | Organization
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Legal Business Name | THE CORNERSTONE OF RECOVERY, INC.
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 5003 HORIZONS DRIVE SUITE 110
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City | COLUMBUS
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State | OH
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Zip | 43220
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Country | US
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Telephone | 614-889-0000
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Fax | 614-846-1916
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Provider Business Mailing Address
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Address Line | 5003 HORIZONS DRIVE SUITE 110
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City | COLUMBUS
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State | OH
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Zip | 43220
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Country | US
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Telephone | 614-889-0000
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Fax | 614-846-1916
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Authorized Official
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Title or Position | DIRECTOR OF OHIO OPERATIONS
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Name | KIMBERLY J BONTA
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Credential | MSW, LICDC, LSW
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Telephone | 614-889-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 12833
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License Number State | OH
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