Provider Demographics
NPI:1467557983
Name:CORNER HOUSE INC
Entity Type:Organization
Organization Name:CORNER HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RILEY-HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC NCC AAPS
Authorized Official - Phone:620-342-3015
Mailing Address - Street 1:PO BOX 931
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-0931
Mailing Address - Country:US
Mailing Address - Phone:620-342-3015
Mailing Address - Fax:620-343-7606
Practice Address - Street 1:418 MARKET STREET
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801
Practice Address - Country:US
Practice Address - Phone:620-342-3015
Practice Address - Fax:620-343-7606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS097261QR0405X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS116096OtherBCBSKS
KS100307180AMedicaid
KS000464OtherBCBSKS