UPI (Provider ID): 12833
Change Report (if Any):

Short Name: CORNERSTONE

Long Name 1: CORNERSTONE OF RECOVERY INC
Long Name 2:

Address 1: 5100 BRADENTON AVENUE
Address 2: SUITE A

City: DUBLIN
Zip Code: 430177567
County: FRAN

Contact: TODD FEASEL
Title: PROGR
Phone: 6148890000
FAX: 6148896599

Vendor: 12833

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012