Organization
CORNERSTONE OF JACKSONVILLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD CORLEY (ADMIN)
(904) 730-5500
Entity
Organization
Contact information
Practice address
9039 BEACH BLVD, JACKSONVILLE, FL 32216-4624
(904) 730-5500
Mailing address
9039 BEACH BLVD, JACKSONVILLE, FL 32216-4624
(904) 730-5500
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90395366
SCHOOL
—
Enumeration date
03/11/2022
Last updated
03/11/2022
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