UPI (Provider ID): 10199
Change Report (if Any):

Short Name: CENTRAL OH MH

Long Name 1: CENTRAL OHIO MENTAL HEALTH
Long Name 2: CENTER

Address 1: 250 SOUTH HENRY STREET
Address 2:

City: DELAWARE
Zip Code: 43015
County: DELA

Contact: CANDI BEAN
Title:
Phone: 7403694482
FAX: 7403687835

Vendor: 10199

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/05/2012

File Produced: 19MAY2012