Provider Demographics
NPI:1154471159
Name:CORNELL INTERVENTIONS, LLC
Entity Type:Organization
Organization Name:CORNELL INTERVENTIONS, LLC
Other - Org Name:CORNELL INTERVENTIONS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:SWATSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-201-4112
Mailing Address - Street 1:2840 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-4775
Mailing Address - Country:US
Mailing Address - Phone:630-968-6477
Mailing Address - Fax:
Practice Address - Street 1:2221 64TH ST
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2180
Practice Address - Country:US
Practice Address - Phone:630-968-6477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-8981-0010-A261QR0405X, 324500000X
ILA-8981-0011-A261QR0405X
ILA89810010A324500000X
ILA89810011A324500000X
ILA8981-0011-A324500000X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder