CORNERSTONE SERVICES INC NPI 1396913539

NPI Information

NPI: 1396913539
Provider Name: CORNERSTONE SERVICES, INC

Other Name: CHEROKEE RIDGE

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization

CLIA Number: 14D2203709

Address:
25058 W LIBERTY DR
CHANNAHON, IL
ZIP 60410
Phone: (815) 741-7045
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CORNERSTONE SERVICES, INC is a community based residential treatment facility, intellectual and/or developmental disabilities in Channahon, IL. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. CORNERSTONE SERVICES, INC NPI is 1396913539. The provider is registered as an organization entity type.
The provider Other Name Is Cherokee Ridge.

The provider's business location address is:

25058 W LIBERTY DR
CHANNAHON, IL
ZIP 60410-181
Phone: (815) 741-7045

The provider's authorized official is Benjamin Stortz .
The authorized official title is Chief Administrative Officer and has the following contact phone number (815) 741-7042.

The CLIA number assigned to this NPI record is 14D2203709 - other - community disability prov with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/11/2008 and was last updated on 6/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========006	OTHER	ILLINOIS	HFS PROVIDER NUMBER
2	000040113	OTHER	ILLINOIS	IDPH LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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