UPI (Provider ID): 13202
Change Report (if Any):

Short Name: SHELTER CARE

Long Name 1: SHELTER CARE
Long Name 2:

Address 1: 32 SOUTH AVENUE
Address 2:

City: TALLMADGE
Zip Code: 44278
County: SUMM

Contact: SUE HARTNEY
Title: CONT
Phone: 3306305600
FAX: 3306305810

Vendor: 60097

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016