Provider Demographics
NPI:1144526419
Name:CORNERSTONE CARE, INC
Entity type:Organization
Organization Name:CORNERSTONE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MTJOY
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:724-943-3308
Mailing Address - Street 1:140 N BEESON AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2937
Mailing Address - Country:US
Mailing Address - Phone:724-439-1628
Mailing Address - Fax:724-439-0171
Practice Address - Street 1:140 N BEESON AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2937
Practice Address - Country:US
Practice Address - Phone:724-439-1628
Practice Address - Fax:724-439-0171
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-04
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
304459OtherAETNA
PA100772557-0022Medicaid
1302933OtherGATEWAY
2504615OtherHIGHMARK
72344OtherUNISON
PA391900Medicare Oscar/Certification
72344OtherUNISON