Cornerstone Living Skills

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

CORNERSTONE LIVING SKILLS

Practice address

920 Baird Rd
Santa Rosa, CA 95409-2711

Phone

(559) 451-0399

NPI assigned

May 25, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nancy Bargmann

Title

Vice President

Phone

(909) 579-3151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baird House Etal Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G770

Legal name

BAIRD HOUSE

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jul 25, 1994

Last certification

Apr 4, 2001

Ownership / control type

OTHER

Facility address

920 Baird Road
Santa Rosa, CA 95409

Tax ID family

Baird House Etal3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Cornerstone Living Skills

  • Intellectual Disabilities Intermediate Care Facility
  • Santa Rosa, CA
  • NPI 1376753376
  NPD tax ID
• Cornerstone Living Skills

  • Intellectual Disabilities Intermediate Care Facility
  • Santa Rosa, CA
  • NPI 1790996320
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609087238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3649 W BEECHWOOD AVE",
            "address_2": "STE 106",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110693",
            "telephone_number": "559-451-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 BAIRD RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092711",
            "telephone_number": "559-451-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE LIVING SKILLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARGMANN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "909-579-3151"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80092F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baird House Etal",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robin Cordova
• Jennie Corella-Nestor
• Kristina Corley
• Christopher Cormier
• Cornerstone Living Skills
• Cornerstone Living Skills
• Glency Sue Marie Senires Corominas, M.D.
• Enrique Corona
• Pablo Sergio Corona, NP-C
• Evelyn Gloria Corrales Bernabe

• Intellectual Disabilities Intermediate Care Facility in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.