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General NPI Number Information
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NPI Number | 1154471159
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Entity Type | Organization
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Legal Business Name | CORNELL INTERVENTIONS, LLC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 2221 64TH ST
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City | WOODRIDGE
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State | IL
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Zip | 60517-2180
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Country | US
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Telephone | 630-968-6477
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 LIBERTY AVE
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City | PITTSBURGH
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State | PA
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Zip | 15222-4775
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Country | US
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Telephone | 630-968-6477
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JON SWATSBURG
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Credential |
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Telephone | 412-201-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | A-8981-0010-A
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | A-8981-0011-A
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | A89810011A
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | A-8981-0010-A
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | A8981-0011-A
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | A89810010A
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License Number State | IL
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