Cornerstone Supportive Care, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CORNERSTONE SUPPORTIVE CARE, LLC

Practice address

1099 Gardenview Loop
304
Woodbridge, VA 22191

Phone

(540) 429-4761

NPI assigned

Aug 12, 2024

Last updated

Aug 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Ann Marek

Title

Executive Director

Phone

(540) 429-4761

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1982435848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11357 NUCKOLS RD # 1044",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595504",
            "telephone_number": "540-429-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 GARDENVIEW LOOP",
            "address_2": "304",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22191",
            "telephone_number": "540-429-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE SUPPORTIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "MAREK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "540-429-4761"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.