Provider Demographics
NPI:1861788457
Name:CORNERSTONE ADULT SERVICES, INC.
Entity type:Organization
Organization Name:CORNERSTONE ADULT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTAGATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-739-2844
Mailing Address - Street 1:140 WARWICK NECK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-5308
Mailing Address - Country:US
Mailing Address - Phone:401-739-2844
Mailing Address - Fax:401-739-5388
Practice Address - Street 1:140 WARWICK NECK AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-5308
Practice Address - Country:US
Practice Address - Phone:401-739-2844
Practice Address - Fax:401-739-5388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI806.00251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI31OtherRESPITE C CARE PROVIDER VENDOR NUMBER
RIV650P-3665OtherVA CONTRACT AWARD NUMBER
RICA03373Medicaid