UPI (Provider ID): 10023
Change Report (if Any):

Short Name: TRILLIUM SOLUTN

Long Name 1: TRILLIUM FAMILY SOLUTIONS INC
Long Name 2:

Address 1: 624 MARKET AVENUE N
Address 2:

City: CANTON
Zip Code: 44702
County: STAR

Contact: JOAN M FIRESTONE
Title:
Phone: 3304547066
FAX: 3304549427

Vendor: 10023

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/30/2011

File Produced: 19MAY2012