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General NPI Number Information
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NPI Number | 1962267591
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Entity Type | Organization
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Legal Business Name | THE CORNERSTONE MN LLC
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 7044 SPRINGHILL CIR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55346-2615
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Country | US
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Telephone | 952-239-3495
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Fax |
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Provider Business Mailing Address
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Address Line | 7044 SPRINGHILL CIR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55346-2615
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Country | US
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Telephone | 952-239-3495
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Fax |
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Authorized Official
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Title or Position | OWNER / TREATMENT DIRECTOR
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Name | BRIDGETTE ROCHELLE DAY
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Credential | LADC
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Telephone | 952-239-3495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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