MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 3340
Change Report (if Any):

Short Name: UNISON BHG

Long Name 1: UNISON BEHAVIORAL HEALTH GROUP
Long Name 2: INC

Address 1: 544 EAST WOODRUFF AVENUE
Address 2:

City: TOLEDO
Zip Code: 436241342
County: LUCA

Contact: COURTNEY WEISS
Title: CODIR
Phone: 4192429577
FAX: 4193216913

Vendor: 3340

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/27/2011

File Produced: 14JUL2016