Cornerstone Supported Living
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Meridian, ID
NPI 1699314443 · NPPES record last updated Dec 26, 2019
Key facts
- NPI
- 1699314443
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- CORNERSTONE SUPPORTED LIVING
- Practice address
- 3400 E River Valley St Apt J202
Meridian, ID 83646-2361 - Phone
- (907) 302-8366
- Fax
- (208) 955-5608
- NPI assigned
- Dec 26, 2019
- Organization subpart
- No
Authorized official
- Name
- Jamila Gilliam
- Title
- Administrator
- Phone
- (907) 302-8366
Practitioners 1
-
Jamila Monique Gilliam, LMSW
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator |
171M00000X | |||
| Home Health Agency | 251E00000X | |||
| Supports Brokerage Agency | 251X00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Assisted Living Facility | 310400000X | |||
| Assisted Living Facility (Mental Illness) | 3104A0625X | |||
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | |||
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | |||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | |||
| Physical Disabilities Residential Treatment Facility | 320700000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes | ||
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Private Vehicle | 347C00000X |
Addresses
Primary practice location
3400 E River Valley St Apt J202
Meridian, ID 83646-2361
Mailing address
3400 E River Valley St Apt J202
Meridian, ID 83646-2361
Phone (907) 302-8366
Other names
- Cornerstone Transport
Other providers in Meridian, ID
- Ann Marie Corey
- Andrea Elizabeth Corliss
- Denise Cornejo-Vucovich
- Jaquelynn Elizabeth Cornelius
- Cornerstone Health PLLC
- Elizabeth Corrao
- Dianira Renee Cortez
- Luis Javier Cortez II
- Sonja Schaff Cortopassi
- Costco Wholesale Corporation
All providers in Meridian, ID · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.