Provider Demographics
NPI:1548670201
Name:THE CORNERSTONE AGENCY OF PA, INC.
Entity type:Organization
Organization Name:THE CORNERSTONE AGENCY OF PA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:717-745-6221
Mailing Address - Street 1:3 EUROPEANA CIR
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1039
Mailing Address - Country:US
Mailing Address - Phone:717-745-6221
Mailing Address - Fax:
Practice Address - Street 1:3 EUROPEANA CIR
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1039
Practice Address - Country:US
Practice Address - Phone:717-745-6221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-04
Last Update Date:2014-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty