UPI (Provider ID): 10024
Change Report (if Any):

Short Name: NE OH BH-STARK

Long Name 1: NORTHEAST OHIO BEHAVIORAL
Long Name 2: HEALTH LTD

Address 1: 2795 FRONT STREET
Address 2: SUITE A

City: CUYAHOGA FALLS
Zip Code: 44221
County: STAR

Contact: RENEE PITTMAN
Title: BSMG
Phone: 3309457100
FAX: .

Vendor: 10034

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/08/2011

File Produced: 14JUL2016