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General NPI Number Information
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NPI Number | 1992275291
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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 | 11/29/2018
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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 | 630-824-4588
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Fax | 630-824-4571
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Provider Business Mailing Address
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Address Line | 2840 LIBERTY AVE STE 300
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City | PITTSBURGH
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State | PA
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Zip | 15222-4776
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Country | US
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Telephone | 630-824-4588
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Fax | 630-824-4571
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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 | 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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