Organization
CORNELL INTERVENTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN SWATSBURG (DIVISIONAL VICE PRESIDENT)
(412) 201-4111
Entity
Organization
Contact information
Practice address
2221 64TH ST, 2ND FLOOR - MEN'S UNIT, WOODRIDGE, IL 60517-2180
(630) 968-6477
Mailing address
2221 64TH ST, WOODRIDGE, IL 60517-2180
(630) 968-6477
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
A-8981-0010-A
IL
324500000X
Substance Abuse Rehabilitation Facility
Primary
A89810010A
IL
Other
Enumeration date
01/21/2016
Last updated
06/29/2016
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