UPI (Provider ID): 1501
Change Report (if Any):

Short Name: GREENLEAF FAM

Long Name 1: GREENLEAF FAMILY CENTER
Long Name 2:

Address 1: 212 EAST EXCHANGE STREET
Address 2:

City: AKRON
Zip Code: 44304
County: SUMM

Contact: JONATHAN APPEL
Title: DIR
Phone: 3303769494
FAX: 3303764525

Vendor: 1501

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/06/2011

File Produced: 14JUL2016