Cornell Corrections of California, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

1526789 Issued in CO

Legal business name

CORNELL CORRECTIONS OF CALIFORNIA, INC.

Practice address

700 Fourmile Pkwy
Canon City, CO 81212-9114

Phone

(719) 276-7500

Fax

(719) 276-6961

NPI assigned

Jan 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Joseph Wilner

Title

Facility Director

Phone

(719) 276-7500

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Cornell Corrections of California Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Cornell Corrections of California, Inc.

  dba Southern Peaks Regional Center

  • Psychiatric Residential Treatment Facility
  • Canon City, CO
  • NPI 1396319141
  NPD tax ID
• Cornell Corrections of California, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canon City, CO
  • NPI 1699269142
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1376689042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 FOURMILE PKWY",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129114",
            "telephone_number": "719-276-7500",
            "fax_number": "719-276-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 FOURMILE PKWY",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129114",
            "telephone_number": "719-276-7500",
            "fax_number": "719-276-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL CORRECTIONS OF CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "WILNER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "FACILITY DIRECTOR",
        "authorized_official_telephone_number": "719-276-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CO",
            "license": "1526789",
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "CO",
            "license": "1526789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42679249",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31487319",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colorado Springs Dermatology Clinic, P.C.
• Colorado Springs Pediatric Dentistry, PC (Colorado Springs Pediatric Dentistry)
• Amber Conover
• Eugene Robert Cook, LCSW
• Michal Cooling, CNTP, MNT
• Cornell Corrections of California, Inc. (Southern Peaks Regional Center)
• Cornell Corrections of California, Inc.
• Emily Cornella, FNP-C
• Counseling Hearts
• Counseling Hearts, PLLC

• Emotionally Disturbed Childrens' Residential Treatment Facility in Canon City, CO
• Providers in Canon City, CO by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.