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General NPI Number Information
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NPI Number | 1760816706
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Entity Type | Organization
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Legal Business Name | CORNERSTONE RECOVERY INC.
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 4130 NE 2ND AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33064-3508
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Country | US
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Telephone | 954-865-4967
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 SOUTH OAKLAND FOREST DRIVE 803
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City | OAKLAND PARK
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State | FL
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Zip | 33309
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Country | US
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Telephone | 954-865-4967
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ANTHONY SMITH SR.
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Credential | C.A.C
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Telephone | 954-865-4967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | FL
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