MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10086
Change Report (if Any):

Short Name: SENIOR RIGHTS

Long Name 1: SENIOR RIGHTS AND ADVOCACY
Long Name 2:

Address 1: 280 NORTH PARK AVENUE
Address 2: SUITE 201

City: WARREN
Zip Code: 44481
County: TRUM

Contact: PATRICIA TOMPKINS
Title: DIR
Phone: 3306752485
FAX: 3306752413

Vendor: 10086

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012