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Organization

CORNERSTONE PROJECT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL WARD (MANAGING PARTNER)
(937) 522-0961
Entity
Organization

Contact information

Practice address
4124 LINDEN AVE, SUITE 100, DAYTON, OH 45432-3018
(937) 522-0961
(937) 522-0951
Mailing address
4124 LINDEN AVE, SUITE 100, DAYTON, OH 45432-3018
(937) 522-0961
(937) 522-0951

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TA0400X
Addiction (Substance Use Disorder) Psychologist
207Q00000X
Family Medicine Physician
207QA0401X
Addiction Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
Primary
207RA0401X
Addiction Medicine (Internal Medicine) Physician
208D00000X
General Practice Physician
291U00000X
Clinical Medical Laboratory

Other

Enumeration date
08/30/2012
Last updated
02/07/2018
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