UPI (Provider ID): 13103
Change Report (if Any):

Short Name: MINORITY BH GP

Long Name 1: AKRON COMMUNITY DEVELOPMENT
Long Name 2: ASSOCIATION DBA MBHG

Address 1: 1293 COPLEY ROAD
Address 2:

City: AKRON
Zip Code: 44320
County: SUMM

Contact: DEBRA STROUD
Title: COO
Phone: 3303741100
FAX: 3303740151

Vendor: 13102

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/20/2011

File Produced: 14JUL2016