Organization
CORNERSTONE MANAGEMENT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE HERNANDEZ (CEO)
(269) 628-2100
Entity
Organization
Contact information
Practice address
302 SOUTH STATE STREET, GOBLES, MI 49055
(269) 628-2100
(269) 628-2121
Mailing address
P.O. BOX 277, BLOOMINGDALE, MI 49026
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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