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CORNERSTONE RESIDENCE OF BAGLEY, INC
NPI 1942436985
Assisted Living Facility in Bagley, MN

Active since June 04, 2009CLIA 24D2004063 · Waiver
30 SUNSET AVE SW, BAGLEY, MN 56621(218) 694-2701(218) 694-2718 Get Directions Write a Review

NPPES record last updated: June 4, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cornerstone Residence Of Bagley, Inc NPPES

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

CORNERSTONE RESIDENCE OF BAGLEY, INC (NPI 1942436985) is a healthcare organization registered as an assisted living facility in Bagley, Minnesota and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through February 23, 2028 and lists Allen Potvin, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1942436985
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCORNERSTONE RESIDENCE OF BAGLEY, INC
Location Address30 SUNSET AVE SWBagley, MN 56621
Mailing Address30 Sunset Ave SwBagley, MN 56621 · (218) 694-2701 · Fax (218) 694-2718
Phone(218) 694-2701
Fax(218) 694-2718
Organization SubpartNo
Authorized OfficialAllen PotvinOwner/president · (218) 435-6205
Enumeration DateJune 4, 2009
✔ NPI 1942436985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
30 SUNSET AVE SW, Bagley, MN 56621
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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 24D2004063

Cornerstone Residence Bagley · Bagley, MN
Active · expires Feb 23, 2028
CLIA Number24D2004063
Laboratory TypeAssisted Living Facility
Certificate Effective DateFebruary 24, 2026
Certificate Expiration DateFebruary 23, 2028
Laboratory DirectorBrandi Coyer
Laboratory Phone(218) 694-2701
Laboratory LocationCornerstone Residence Bagley30 Sunset Avenue SW, Bagley, MN 56621
CLIA data matches this NPI record on: Address Phone
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 Residence Of Bagley, Inc's NPI number?

The NPI number for Cornerstone Residence Of Bagley, Inc is 1942436985. It was assigned to this organization in the NPPES registry on June 4, 2009.

Where is Cornerstone Residence Of Bagley, Inc located?

Cornerstone Residence Of Bagley, Inc is located at 30 Sunset Ave SW, Bagley, MN 56621. The listed phone number is (218) 694-2701.

What is Cornerstone Residence Of Bagley, Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Cornerstone Residence Of Bagley, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2004063) is associated with this NPI, valid through February 23, 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 Residence Of Bagley, Inc was last updated on June 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.