UPI (Provider ID): 1018
Change Report (if Any):

Short Name: TRI-CNTY MENTAL

Long Name 1: TRI COUNTY MENTAL HEALTH
Long Name 2: AND COUNSELING SERVICES INC

Address 1: 90 HOSPITAL DRIVE
Address 2:

City: ATHENS
Zip Code: 45701
County: ATHE

Contact: KATHY KOSKA
Title: ITAD
Phone: 7405945045
FAX: 7405945642

Vendor: 1018

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/09/2012

File Produced: 19MAY2012