UPI (Provider ID): 1565
Change Report (if Any):

Short Name: HB CFIT CSN

Long Name 1: HB CHILD AND FAMILY
Long Name 2: INTERVENTION TEAM CSN

Address 1: 3076 A REMSEN ROAD
Address 2:

City: MEDINA
Zip Code: 44256
County: MEDI

Contact: CHARLES JOHNSTON
Title:
Phone: 3307220750
FAX: 3307230068

Vendor: 3275

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016