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CORNELL CORRECTIONS OF CALIFORNIA INC. NPI 1376689042


NPI Information

NPI: 1376689042
Provider Name: CORNELL CORRECTIONS OF CALIFORNIA, INC.
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
700 FOURMILE PKWY
CANON CITY, CO
ZIP 81212
Phone: (719) 276-7500
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CORNELL CORRECTIONS OF CALIFORNIA, INC. is a residential treatment facility emotionally disturbed children in Canon City, CO. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. CORNELL CORRECTIONS OF CALIFORNIA, INC. NPI is 1376689042. The provider is registered as an organization entity type.

The provider's business location address is:

700 FOURMILE PKWY
CANON CITY, CO
ZIP 81212-114
Phone: (719) 276-7500
Fax: (719) 276-6961

The provider's authorized official is Joseph Wilner .
The authorized official title is Facility Director and has the following contact phone number (719) 276-7500.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 6/29/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1323P00000XPsychiatric Residential Treatment Facility1526789COLORADONo
2322D00000XResidential Treatment Facility, Emotionally Disturbed Children1526789COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
131487319MEDICAIDCOLORADO
242679249MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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