UPI (Provider ID): 10078
Change Report (if Any):

Short Name: NE OH ADOPTION

Long Name 1: NORTHEAST OHIO ADOPTION
Long Name 2: SERVICES

Address 1: 8029 EAST MARKET STREET
Address 2:

City: WARREN
Zip Code: 44484
County: TRUM

Contact: GAIL KNAPP
Title: MIS
Phone: 3308565582
FAX: 3308565586

Vendor: 10078

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012