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Organization

CORNERSTONE SERVICES, INC

Active
Parent organization
CORNERSTONE SERVICES, INC
Other names
Autumn Lake
Organization subpart
Yes

Provider details

NPI number
Legal business name
CORNERSTONE SERVICES, INC
Authorized official
MR. BENJAMIN STORTZ (CHIEF ADMINISTRATIVE OFFICER)
(815) 741-7042
Entity
Organization

Contact information

Practice address
3515 THEODORE ST, JOLIET, IL 60431-2884
(815) 741-7045
Mailing address
777 JOYCE RD, JOLIET, IL 60436-1876
(815) 741-7045

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000040105
IDPH LICENSE NUMBER
IL
Enumeration date
02/11/2008
Last updated
06/12/2008
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