MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 3488
Change Report (if Any):

Short Name: CHILD GUIDE CTR

Long Name 1: CHILD GUIDANCE AND FAMILY
Long Name 2: SOLUTIONS

Address 1: 312 LOCUST STREET
Address 2:

City: AKRON
Zip Code: 443021878
County: SUMM

Contact: MARY SAFRON
Title: BILL
Phone: 3307620591
FAX: 3307622242

Vendor: 3488

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/19/2011

File Produced: 14JUL2016