Provider Demographics
NPI:1689925141
Name:CORNERSTONE CARE INC.
Entity type:Organization
Organization Name:CORNERSTONE CARE INC.
Other - Org Name:<UNAVAIL>
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:
Authorized Official - Phone:724-943-3308
Mailing Address - Street 1:1227 SMITH TOWNSHIP STATE RD
Mailing Address - Street 2:
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-2828
Mailing Address - Country:US
Mailing Address - Phone:724-947-2251
Mailing Address - Fax:724-947-2477
Practice Address - Street 1:1227 SMITH TOWNSHIP STATE RD
Practice Address - Street 2:
Practice Address - City:BURGETTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15021-2828
Practice Address - Country:US
Practice Address - Phone:724-947-2251
Practice Address - Fax:724-947-2477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007725570005Medicaid
PA068116Medicare PIN
PA1007725570005Medicaid