Organization
CORNELL CORRECTIONS OF CALIFORNIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WILNER (FACILITY DIRECTOR)
(719) 276-7500
Entity
Organization
Contact information
Practice address
700 FOURMILE PKWY, CANON CITY, CO 81212-9114
(719) 276-7500
(719) 276-6961
Mailing address
700 FOURMILE PKWY, CANON CITY, CO 81212-9114
(719) 276-7500
(719) 276-6961
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1526789
CO
323P00000X
Psychiatric Residential Treatment Facility
1526789
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31487319
—
CO
05
—
42679249
—
CO
Enumeration date
01/30/2007
Last updated
06/29/2012
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