Organization
CORNERSTONE SUPPORTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANTILLA E BOATENG (CO-OWNER)
(614) 882-4499
Entity
Organization
Contact information
Practice address
519 S. OTTERBEIN AVE. SUITE 7, WESTERVILLE, OH 43081
(614) 882-4499
(614) 882-4491
Mailing address
519 S. OTTERBEIN AVE. SUITE 7, WESTERVILLE, OH 43081
(614) 882-4499
(614) 882-4491
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
2830333
OH
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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