CORNERSTONE MANOR I LLC
NPI 1073326237
Assisted Living Facility - Assisted Living, Mental Illness in Scottsville, KY

Active since January 30, 2025CLIA 18D1041660 · Waiver
515 WATER ST, SCOTTSVILLE, KY 42164(516) 708-3503 Get Directions Write a Review

NPPES record last updated: January 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cornerstone Manor I Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CORNERSTONE MANOR I LLC (NPI 1073326237) is a healthcare organization registered as an assisted living, mental illness in Scottsville, Kentucky and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through February 15, 2028 and lists Raquel Edery, Coo, as its authorized official.

NPPES Registry Identity

NPI1073326237
Entity TypeOrganization
Primary Taxonomy3104A0625X
Legal Business NameCORNERSTONE MANOR I LLC
Location Address515 WATER STScottsville, KY 42164-1167
Mailing Address455 Central Ave Ste 215Cedarhurst, NY 11516-2008 · (516) 708-3503
Organization SubpartNo
Authorized OfficialRaquel EderyCoo · (516) 708-3503
Enumeration DateJanuary 30, 2025
NPPES CertifiedJanuary 30, 2025
NPI 1073326237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities
Taxonomy Code3104A0625X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
515 WATER ST, Scottsville, KY 42164

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D1041660

Cornerstone Manor I LLC · Scottsville, KY
Active · expires Feb 15, 2028
CLIA Number18D1041660
Laboratory TypePersonal Care Home
Certificate Effective DateFebruary 16, 2026
Certificate Expiration DateFebruary 15, 2028
Laboratory DirectorMr. Bradley G. Amberly
Laboratory Phone(917) 558-7558
Laboratory LocationCornerstone Manor I LLC515 Water St, Scottsville, KY 42164
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cornerstone Manor I LLC's NPI number?

The NPI number for Cornerstone Manor I LLC is 1073326237. It was assigned to this organization in the NPPES registry on January 30, 2025.

Where is Cornerstone Manor I LLC located?

Cornerstone Manor I LLC is located at 515 Water St, Scottsville, KY 42164. The listed phone number is (516) 708-3503.

What is Cornerstone Manor I LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Does Cornerstone Manor I LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D1041660) is associated with this NPI, valid through February 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cornerstone Manor I LLC was last updated on January 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.