- Enrollment id
- O20090724000643
- Enrollment state
- FL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1619028313
- Multiple npi flag
- N
- Ccn
- 101525
- Associate id
- 5597818435
- Organization name
- CORNERSTONE HOSPICE & PALLIATIVE CARE INC
- Doing business as name
- CORNERSTONE HOSPICE
- Incorporation date
- 1988-07-28
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 2445 LANE PARK ROAD
- City
- TAVARES
- State
- FL
- Zip code
- 327789648