| Organization Name: | CORNERSTONE FAMILY CARE, LLC |
| NPI Number: | 1417302506 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTOPHER L GAMBLE (MANAGING MEMBER) |
| Mailing Address: | 387 Lake Havasu Ave S Ste 102 Lake Havasu City |
| State: | AZ US |
| Postal Code: | 864039306 |
| Phone Number: | 9288550005 |
| Fax Number: | |
| NPI Enumeration Date: | 04/26/2016 |
| NPI Last Update Date: | 04/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 347C00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Private Vehicle |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |