CORNERSTONE ASSISTED LIVING (NPI# 1720118342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720118342 |
| Entity Type | Organization |
| Organization Name | CORNERSTONE ASSISTED LIVING |
| Other Organization Name | CORNERSTONE BROADMOOR |
| Practice Address |
1240 N Broadmoor Ave Wichita KS 67206-3896 |
| Practice Telephone | 3166365101 |
| Practice Fax Number | 3166362576 |
| Mailing Telephone | 3166365101 |
| Mailing Fax Number | 3166362576 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIAM J SLATER (VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 3169465215 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | N087041 | KS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200104501083 | 05 |
| Other Name | Type Code |
|---|---|
| Cornerstone Broadmoor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770707929 | Cornerstone Assisted Living | Assisted Living Facility | 424 Glovenia St, Eden, NC 27288-4844 | 2007-04-12 |
| 1427103977 | Cornerstone Assisted Living | Assisted Living Facility | 3636 N Ridge Rd, Building 400, Wichita, KS 67205-1213 | 2007-01-24 |
| 1508911074 | Cornerstone Assisted Living | Assisted Living Facility | 1240 N Broadmoor Ave, Wichita, KS 67206-3896 | 2007-01-24 |
| 1467600122 | Cornerstone Assisted Living | Assisted Living Facility | 424 Glovenia St, Eden, NC 27288-4844 | 2008-09-05 |
| 1891967923 | Cornerstone Assisted Living | Assisted Living Facility | 424 Glovenia St, Eden, NC 27288-4844 | 2008-03-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Cornerstone Assisted Living LLC | 6808 Grandview Ave, Arvada, CO 80002 |
| Street Address |
1240 N BROADMOOR AVE |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-3896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508911074 | Cornerstone Assisted Living | Assisted Living Facility | 1240 N Broadmoor Ave, Wichita, KS 67206-3896 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1174006613 | Courtney Dawn Simon | Physical Therapist | 9360 E Central Ave Ste 100, Wichita, KS 67206 | 2018-09-11 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1750804597 | Katelyn Aguiar | Psychologist | 250 N Rock Rd Ste 210, Wichita, KS 67206 | 2017-07-24 |
| 1457888778 | Mona Kay Cherryholmes | Social Worker | 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 | 2017-05-17 |
| 1164899415 | Elizabeth Herl | Marriage & Family Therapist | 250 N Rock Rd Ste 150, Wichita, KS 67206 | 2015-08-21 |
| 1851715510 | Ndjj Corp | Custodial Care Facility | 6403 E Marjore, Wichita, KS 67206 | 2014-02-14 |
| 1801238217 | Courtney Ann Lang | Physical Therapist | 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 | 2013-07-26 |
| 1194063032 | Peak Performance Health Pa | Chiropractor | 10111 E 21st St, #106, Wichita, KS 67206 | 2013-01-28 |
| 1750629002 | Rachel Marie Conrad | Speech-Language Pathologist | 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 | 2013-01-22 |
| Find all providers in zip 67206 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750908091 | Agape Home Plus LLC | Assisted Living Facility | 6322 Peach Tree Ln, Wichita, KS 67218-1820 | 2020-07-02 |
| 1497255111 | Almost-home Home Plus LLC | Assisted Living Facility | 5516 Polo Dr, Wichita, KS 67208-2752 | 2018-02-19 |
| 1003321696 | Grace Cottage LLC | Assisted Living Facility | 531 N Crestline St, Wichita, KS 67212-4618 | 2017-12-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1184173304 | Fusion Senior Care Homes Plus LLC | Assisted Living Facility | 512 N Bebe St, Wichita, KS 67212-2328 | 2016-09-29 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1215302278 | Golden Boomers Home Plus LLC | Assisted Living Facility | 6953 E Kentford Cir, Wichita, KS 67226-1026 | 2015-12-02 |
| 1710226147 | Meridian West - Chaucer LLC | Assisted Living Facility | 10550 E 21st St N, Wichita, KS 67206-3509 | 2013-02-05 |
| 1922347640 | Accord Senior Care Inc. | Assisted Living Facility | 6311 E. Marjorie, Wichita, KS 67208-3629 | 2013-02-01 |
| 1932458106 | West Wichita Assisted Living, LLC | Assisted Living Facility | 629 S. Maize Ct, Wichita, KS 67209 | 2012-09-04 |
| Find all providers in WICHITA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.