# CORNELL CORRECTIONS OF TEXAS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952434896
- **Authorized official:** MISS MICHELLE ANN MARTENSON (BUSINESS MANAGER)
- **Authorized official phone:** (210) 568-8600

## Contact information

- **Practice address:** 620 E AFTON OAKS BLVD, SAN ANTONIO, TX 78232-1236
- **Practice address phone:** (210) 568-8600
- **Practice address fax:** (210) 490-9430
- **Mailing address:** 620 E AFTON OAKS BLVD, SAN ANTONIO, TX 78232-1236
- **Mailing address phone:** (210) 568-8600
- **Mailing address fax:** (210) 490-9430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 10/22/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 109325402 | — | TX |