UPI (Provider ID): 3249
Change Report (if Any):

Short Name: CLER REC-1088

Long Name 1: CLERMONT RECOVERY CENTER INC
Long Name 2:

Address 1: 1088 WASSERMAN ROAD
Address 2:

City: BATAVIA
Zip Code: 45103
County: CLER

Contact: STEVE GOLDSBERRY
Title: CEO
Phone: 5137358100
FAX: 5137358156

Vendor: 3249

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/09/2011

File Produced: 19MAY2012