Basic Information
| Provider Information | |||||||||
| NPI: | 1699964148 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CORNERSTONE BEHAVIORAL HEALTH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1705 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712017046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183258048 | ||||||||
| FaxNumber: | 3183255385 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 KILPATRICK BLVD STE 102 | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712015156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183258048 | ||||||||
| FaxNumber: | 3183255385 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2007 | ||||||||
| LastUpdateDate: | 10/01/2019 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | ADRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3183258048 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.