MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10285
Change Report (if Any):

Short Name: FAMILY CRISIS

Long Name 1: FAMILY CRISIS NETWORK
Long Name 2:

Address 1: PO BOX 632
Address 2:

City: CELINA
Zip Code: 45822
County: MERC

Contact: JOYCE BORGER
Title: DIR
Phone: 4195864663
FAX: .

Vendor: 10285

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012