UPI (Provider ID): 10018
Change Report (if Any):

Short Name: ST JOE-DAYTON

Long Name 1: ST JOSEPH CHILDRENS
Long Name 2: TREATMENT CENTER

Address 1: 650 ST PAUL AVENUE
Address 2:

City: DAYTON
Zip Code: 45410
County: MONT

Contact: ROBERT WEHR
Title: EXDIR
Phone: 9372543562
FAX: 9372546777

Vendor: 10018

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012