Organization
CORNERSTONE II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACIE ANN HERNANDEZ (CEO)
(269) 317-4433
Entity
Organization
Contact information
Practice address
22722 W M 43, KALAMAZOO, MI 49009-9208
(269) 668-7419
(269) 668-7419
Mailing address
P.O. BOX 277, BLOOMINGDALE, MI 49026
(269) 628-2100
(269) 628-2121
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AS800309333
MI
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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