Organization
CORNERSTONE SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DESMOND MATHEWS (PRESIDENT/CEO)
(317) 755-2731
Entity
Organization
Contact information
Practice address
6214 MORENCI TRL, SUITE 100, INDIANAPOLIS, IN 46268-2574
(317) 755-2731
Mailing address
6214 MORENCI TRL, SUITE 100, INDIANAPOLIS, IN 46268-2574
(317) 755-2731
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/16/2014
Last updated
09/14/2017
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