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General NPI Number Information
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NPI Number | 1972744704
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Entity Type | Organization
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Legal Business Name | CORNERSTONE COMMUNITY SUPPORT SERVICES, INC.
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Dates
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Enumeration Date | 03/06/2009
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 127B WEST MAIN STREET
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City | SPRINGHOPE
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State | NC
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Zip | 27882-9424
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Country | US
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Telephone | 252-478-3605
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Fax | 252-478-3718
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Provider Business Mailing Address
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Address Line | 127B WEST MAIN STREET
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City | SPRINGHOPE
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State | NC
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Zip | 27882-9424
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Country | US
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Telephone | 252-235-2536
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Fax | 252-235-2816
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHERYL MERCER
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Credential |
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Telephone | 252-478-3605
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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 | MHL-064-105
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License Number State | NC
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