UPI (Provider ID): 13094
Change Report (if Any):

Short Name: COMM SUPPORT-WL

Long Name 1: COMMUNITY SUPPORT SERVICES
Long Name 2:

Address 1: 640 WOLF LEDGES PKWY
Address 2:

City: AKRON
Zip Code: 44311
County: SUMM

Contact: TERRENCE B DALTON
Title: PRES
Phone: 3309969141
FAX: 3302530377

Vendor: 10033

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 06/27/2012

File Produced: 14JUL2016