MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 12835
Change Report (if Any):

Short Name: E AKRON COMMNTY

Long Name 1: EAST AKRON COMMUNITY HOUSE
Long Name 2:

Address 1: 550 SOUTH ARLINGTON STREET
Address 2:

City: AKRON
Zip Code: 44306
County: SUMM

Contact: KELLY BURR
Title: BSMG
Phone: 3307736838
FAX: 3307730345

Vendor: 12835

Reports Status: CLIAMS/NO

MACSIS Last Update Date: 01/10/2012

File Produced: 14JUL2016