Provider Demographics
NPI:1053177782
Name:CORNERSTONE SERVICES, INC
Entity type:Organization
Organization Name:CORNERSTONE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STORTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-741-7042
Mailing Address - Street 1:530 E 162ND ST # 545
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2326
Mailing Address - Country:US
Mailing Address - Phone:815-727-6666
Mailing Address - Fax:
Practice Address - Street 1:530 E 162ND ST
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2326
Practice Address - Country:US
Practice Address - Phone:815-727-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)