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General NPI Number Information
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NPI Number | 1790575405
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Entity Type | Organization
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Legal Business Name | CORNERSTONE RECOVERY LLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 102 COLONY PARK DR STE 800
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City | CUMMING
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State | GA
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Zip | 30040-2790
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Country | US
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Telephone | 678-858-8748
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Fax |
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Provider Business Mailing Address
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Address Line | 102 COLONY PARK DR STE 800
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City | CUMMING
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State | GA
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Zip | 30040-2790
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORGANIZER/ADMINISTRATOR
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Name | MR. SAMUEL ZOERB
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Credential |
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Telephone | 209-595-8587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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