Organization
CORNER STONE RESIDENTIAL CARE, LLC
Active
Other names
Limited Liability Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD MACK JOHNSON MBA (DIRECTOR)
(919) 452-9276
Entity
Organization
Contact information
Practice address
2316 NELSON HWY, CHAPEL HILL, NC 27517
(919) 402-8477
Mailing address
1537 YORKSHIRE LANE, ROCKY MOUNT, NC 27803
(252) 937-7862
(252) 451-4111
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-032-336
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603843
—
NC
Enumeration date
11/29/2006
Last updated
11/03/2009
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