Basic Information
| Provider Information | |||||||||
| NPI: | 1053649822 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CORNERSTONE HOME HEALTH CARE LLC | ||||||||
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| OtherOrganizationName: | CORNERSTONE HOME HEALTH CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 FAIRVIEW ST | ||||||||
| Address2: | |||||||||
| City: | ROSLINDALE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021311629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177672793 | ||||||||
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| Practice Location | |||||||||
| Address1: | 24 FAIRVIEW ST | ||||||||
| Address2: | |||||||||
| City: | ROSLINDALE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021311629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177672793 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2009 | ||||||||
| LastUpdateDate: | 12/05/2009 | ||||||||
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| AuthorizedOfficialLastName: | CALLAHAN | ||||||||
| AuthorizedOfficialFirstName: | MARGARET | ||||||||
| AuthorizedOfficialMiddleName: | HARVEY | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6177672793 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | APRN-BC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.