UPI (Provider ID): 13111
Change Report (if Any):

Short Name: CHOICES BH

Long Name 1: CHOICES BEHAVIORAL HEALTH CARE
Long Name 2:

Address 1: 350 NORTH IRWIN ROAD
Address 2:

City: HOLLAND
Zip Code: 43528
County: LUCA

Contact: GERD HEIDINGER
Title: VPFIN
Phone: 4194641653
FAX: 2033041848

Vendor: 13101

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/27/2012

File Produced: 14JUL2016