Organization
CORNERSTONE ADULT FAMILY HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW JACKSON (OWNER)
(262) 248-6302
Entity
Organization
Contact information
Practice address
N3445 COMO RD STOP 7, LAKE GENEVA, WI 53147-2658
(262) 248-6302
(262) 248-6301
Mailing address
N3445 COMO RD STOP 7, LAKE GENEVA, WI 53147-2658
(262) 248-6302
(262) 248-6301
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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