Cornerstone I Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

AM800267076 Issued in MI

Legal business name

CORNERSTONE I INC.

Practice address

59859 M 43
Bangor, MI 49013-9617

Phone

(269) 628-2100

Fax

(269) 628-2121

NPI assigned

Jan 7, 2011

Last updated

Jan 7, 2011By 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

Mrs. Tracie Ann Hernandez

Title

Ceo

Phone

(269) 317-4433

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294358400000",
    "number": "1467756221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "BLOOMINGDALE",
            "state": "MI",
            "postal_code": "490260277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59859 M 43",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490139617",
            "telephone_number": "269-628-2100",
            "fax_number": "269-628-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE I INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "269-317-4433",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AM800267076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bronson Lakeview Hospital (Bronson LakeView Family Care Bangor)
• Francine M Bruder, M.D.
• Karla Michelle Carr, RDH
• Nancy Cerny, RDH
• Randal Cieslak, DO
• Craig M. Herrmann, D.D.S.,P.L.C
• Caralyn Dehaan, D.O.
• Engedi Homes, Inc.
• Terryl Ensign, R.PH
• Rebekah Lee Fatzinger, LLP, LMSW

• Mental Illness Community Based Residential Treatment Facility in Bangor, MI
• Providers in Bangor, MI by specialty
• Mental Illness Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.