Organization
CORNERSTONE SUPPORTIVE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN MAREK (EXECUTIVE DIRECTOR)
(540) 429-4761
Entity
Organization
Contact information
Practice address
1099 GARDENVIEW LOOP, 304, WOODBRIDGE, VA 22191
(540) 429-4761
Mailing address
11357 NUCKOLS RD # 1044, GLEN ALLEN, VA 23059-5504
(540) 429-4761
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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