UPI (Provider ID): 10195
Change Report (if Any):

Short Name: NEW HORIZONS

Long Name 1: NEW HORIZONS YOUTH AND FAMILY
Long Name 2: CENTER

Address 1: 1592 GRANVILLE PIKE
Address 2:

City: LANCASTER
Zip Code: 43130
County: FAIR

Contact: SUSAN GARRETT
Title: DIR
Phone: 7406870835
FAX: 7406879391

Vendor: 10195

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/21/2011

File Produced: 19MAY2012