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Organization
CORNERSTONE RESTORATION AND TRAINING SERVICES
Active
Organization
CORNERSTONE RESTORATION AND TRAINING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIS O. HENDERSON ED.D, M.DIV (OWNER)
(804) 852-7645
Entity
Organization
Contact information
Practice address
1700 BLAIR ST, RICHMOND, VA 23220-6406
(804) 852-7645
Mailing address
4411 WISTAR RD, HENRICO, VA 23228-2640
(804) 852-7645
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0904006909
VA
Other
Enumeration date
06/09/2017
Last updated
06/20/2018
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