Cornerstone Behavioral Health Services Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1843-03-002 Issued in VA

Legal business name

CORNERSTONE BEHAVIORAL HEALTH SERVICES INC

Practice address

125 N Mecklenburg Ave
South Hill, VA 23970-2045

Phone

(434) 584-9845

Fax

(434) 584-9810

NPI assigned

Nov 16, 2016

Last updated

Jul 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

George BreedloveNPI 1376116756

Title

Ceo, Owner

Phone

(804) 248-7367

Specialties & licenses 1

Addresses

Other names 1

• Gentlemen of Tomorrow LLC Former legal business name

Tax ID family

Cornerstone Behavioral Health Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cornerstone Behavioral Health Services Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Danville, VA
  • NPI 1801271366
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Breedlove

  • Community/Behavioral Health Agency
  • South Hill, VA
  • NPI 1376116756
  NPD Authorized official

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1063954469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N MECKLENBURG AVE",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239702045",
            "telephone_number": "434-584-9845",
            "fax_number": "434-584-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N MECKLENBURG AVE",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239702045",
            "telephone_number": "434-584-9845",
            "fax_number": "434-584-9810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 N Union St",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "VA",
            "postal_code": "245411030",
            "country_code": "US",
            "telephone_number": "804-562-4748",
            "fax_number": "804-303-8117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1618 Hull St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232243806",
            "country_code": "US",
            "telephone_number": "804-562-4768",
            "fax_number": "804-303-8117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Twinridge Ln",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232355241",
            "country_code": "US",
            "telephone_number": "804-562-4748",
            "fax_number": "804-303-8117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORNERSTONE BEHAVIORAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "BREEDLOVE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "804-248-7367"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1843-03-002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentlemen of Tomorrow LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Community Memorial Hospital
• Community Memorial Hospital
• Community Memorial Hospital
• Community Memorial Hospital
• Fortunata S Condecido, FNP-BC
• Heather Morris Corwin, PHARMD
• Diana P Crowder, PAC
• Kristen Damon, FNP
• Hayley Daniel
• Jacob A Davis, CRNA

• Community/Behavioral Health Agency in South Hill, VA
• Providers in South Hill, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.