UPI (Provider ID): 2308
Change Report (if Any):

Short Name: YOUTH SER-SUMM

Long Name 1: YOUTH DEVELOPMENT CENTER
Long Name 2: SUBSTANCE ABUSE UNIT

Address 1: 996 HINES HILL ROAD
Address 2:

City: HUDSON
Zip Code: 44236
County: SUMM

Contact: MAUREEN WEIGAND
Title: MNG
Phone: 3306562282
FAX: 3304635552

Vendor: 10342

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016