Provider Demographics
NPI:1043340052
Name:CORNELL ABRAXAS GROUP, INC.
Entity Type:Organization
Organization Name:CORNELL ABRAXAS GROUP, INC.
Other - Org Name:CORNELL COMPANIES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SWATSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-208-4000
Mailing Address - Street 1:2840 LIBERTY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-4706
Mailing Address - Country:US
Mailing Address - Phone:412-208-4000
Mailing Address - Fax:412-227-0801
Practice Address - Street 1:10058 S MOUNTAIN RD
Practice Address - Street 2:BUILDING #3
Practice Address - City:SOUTH MOUNTAIN
Practice Address - State:PA
Practice Address - Zip Code:17261-0900
Practice Address - Country:US
Practice Address - Phone:717-749-3066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA304420322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children