Organization
CORNERSTONE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE LENORE LEWIS (OWNER)
(336) 589-8197
Entity
Organization
Contact information
Practice address
424 GLOVENIA ST, EDEN, NC 27288-4844
(336) 627-6627
Mailing address
PO BOX 1115, REIDSVILLE, NC 27323-1115
(336) 589-8197
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-079-058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804954
—
NC
Enumeration date
04/12/2007
Last updated
08/22/2020
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