Provider Demographics
NPI:1225183494
Name:CORNELL INTERVENTIONS, INC.
Entity Type:Organization
Organization Name:CORNELL INTERVENTIONS, INC.
Other - Org Name:CORNELL COMPANIES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIVISIONAL VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:SWATSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-201-4111
Mailing Address - Street 1:5701 S WOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60636-1646
Mailing Address - Country:US
Mailing Address - Phone:773-737-4600
Mailing Address - Fax:
Practice Address - Street 1:5701 S WOOD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-1646
Practice Address - Country:US
Practice Address - Phone:773-737-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-8981-0005-A261QR0405X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder