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General NPI Number Information
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NPI Number | 1700337656
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Entity Type | Organization
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Legal Business Name | CORNERSTONE DELIVERANCE & DEVELOPMENT MINISTRIES FOR CHRIST, INC
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Dates
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Enumeration Date | 10/16/2016
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 441 NW 35TH AVENUE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311
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Country | US
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Telephone | 954-526-4117
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Fax | 954-827-0285
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Provider Business Mailing Address
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Address Line | 3090 NW 7TH STREET
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-7612
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Country | US
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Telephone | 954-526-4117
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ANDREW J. JONES
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Credential |
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Telephone | 954-642-1583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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