Cornerstone Addiction Recovery Services LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

CORNERSTONE ADDICTION RECOVERY SERVICES LLC

Practice address

185 NE 4TH St
Prineville, OR 97754-1934

Phone

(971) 312-2091

NPI assigned

Mar 30, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patricia Short, LPCNPI 1124440813

Title

Administrator

Phone

(971) 312-2091

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Short, LPC

  • Professional Counselor
  • Prineville, OR
  • NPI 1124440813
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1043950868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 NE COURT ST UNIT 798",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977540656",
            "telephone_number": "971-312-2091",
            "fax_number": "971-256-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 NE 4TH ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541934",
            "telephone_number": "971-312-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE ADDICTION RECOVERY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "971-312-2091",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124440813",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "185 NE 4th St",
            "city": "Prineville",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977541934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Lee Coffman, RN
• Alyssa Joann Colby, IBCLC, CHW
• Shyla Colovos
• Linda Joyce Cook, PHD LCSW
• Siobhan Katherine Cooper, M.D., MPH
• Dominique Marie Cotherman
• County of Crook
• County of Crook
• Kendra Leann Coyle, CRM
• Joleigh Creason

• Substance Abuse Rehabilitation Facility in Prineville, OR
• Providers in Prineville, OR by specialty
• Substance Abuse Rehabilitation Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.