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Organization

CORNERSTONE COMMUNITY LIVING INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SPENCER ELIJAH JACKSON JR. PROVIDER (DIRECTOR PROGRAM MANAGER)
(281) 687-2173
Entity
Organization

Contact information

Practice address
5918 HAVENWOODS DR, HOUSTON, TX 77066-2335
(281) 687-2173
(281) 580-4962
Mailing address
5918 HAVENWOODS DR, HOUSTON, TX 77066-2335
(281) 687-2173
(281) 580-4962

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary

Other

Enumeration date
01/29/2008
Last updated
01/29/2008
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