Organization Name: | CORNERSTONE PROGRAMS CORPORATION |
NPI Number: | 1710263652 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH P NEWMAN (CEO) |
Mailing Address: | 3304 E I-80 Service Rd Cheyenne |
State: | WY US |
Postal Code: | 820098781 |
Phone Number: | 3076338040 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2011 |
NPI Last Update Date: | 10/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2008-000552445 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |