UPI (Provider ID): 10163
Change Report (if Any):

Short Name: THOMPKINS-NWCON

Long Name 1: THOMPKINS CHILD AND ADOLESCENT
Long Name 2: SERVICES INC

Address 1: 211 WATSON AVENUE
Address 2: PO BOX 185

City: BYESVILLE
Zip Code: 437230185
County: GUER

Contact: NANCY YERIAN
Title: SUPV
Phone: 7406852000
FAX: 7406852001

Vendor: 10163

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/20/2011

File Produced: 19MAY2012