CSIS PROVIDER (PROVF) SUMMARY SHEET
UPI (Provider ID): 10177
Change Report (if Any):
Short Name: YWCA RES PROG
Long Name 1: YWCA RESIDENCE PROGRAM
Long Name 2:
Address 1: 244 DAYTON STREET
Address 2:
City: HAMILTON
Zip Code: 45011
County: BUTL
Contact: ANITA HOWARD
Title: EX DR
Phone: 5138569800
FAX: .
Vendor: 10177
Reports Status: CLAIMS/NO
MACSIS Last Update Date: 12/28/2011
File Produced: 19MAY2012