Organization
CORNERSTONE ADDICTION RECOVERY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA SHORT LPC (ADMINISTRATOR)
(971) 312-2091
Entity
Organization
Contact information
Practice address
185 NE 4TH ST, PRINEVILLE, OR 97754-1934
(971) 312-2091
Mailing address
155 NE COURT ST UNIT 798, PRINEVILLE, OR 97754-0656
(971) 312-2091
(971) 256-8853
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124440813
—
OR
Enumeration date
03/30/2022
Last updated
03/30/2022
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