Provider Demographics
NPI:1396319141
Name:CORNELL CORRECTIONS OF CALIFORNIA, INC.
Entity type:Organization
Organization Name:CORNELL CORRECTIONS OF CALIFORNIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-208-4000
Mailing Address - Street 1:700 FOUR MILE PKWY
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-9114
Mailing Address - Country:US
Mailing Address - Phone:719-276-7500
Mailing Address - Fax:719-276-6961
Practice Address - Street 1:700 FOUR MILE PKWY
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-9114
Practice Address - Country:US
Practice Address - Phone:719-276-7500
Practice Address - Fax:719-276-6961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNELL CORRECTIONS OF CALIFORNIA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility