| Cornerstone Behavioral Health | |
|
50 Allegiance Cir Evanston WY 82930-3804 | |
| (307) 789-3710 | |
| (307) 789-0823 |
| Full Name | Cornerstone Behavioral Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 50 Allegiance Cir, Evanston, Wyoming |
| Authorized Official Name and Position | John Holderegger (CEO) |
| Authorized Official Contact | 3077893710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Behavioral Health Po Box 6005 Evanston WY 82931-6005 Ph: (307) 789-3710 | Cornerstone Behavioral Health 50 Allegiance Cir Evanston WY 82930-3804 Ph: (307) 789-3710 |
| NPI Number | 1851502397 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 10/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851502397 | NPI | - | NPPES |
| 118767800 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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