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General NPI Number Information
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NPI Number | 1922207018
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Entity Type | Organization
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Legal Business Name | CORNERSTONE DAY TREATMENT PROGRAM
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 9551 N STATE ST
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City | REDWOOD VALLEY
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State | CA
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Zip | 95470-6409
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Country | US
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Telephone | 707-485-1301
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Fax | 707-485-7944
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Provider Business Mailing Address
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Address Line | 9551 N STATE ST
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City | REDWOOD VALLEY
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State | CA
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Zip | 95470-6409
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Country | US
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Telephone | 707-485-1301
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Fax | 707-485-7944
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Authorized Official
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Title or Position | CLINICIAN
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Name | MRS. MARSHA THATCHER
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Credential | MFT
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Telephone | 707-485-1301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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