MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10293
Change Report (if Any):

Short Name: COMMUNITY HOUSE

Long Name 1: COMMUNITY HOUSING INC
Long Name 2:

Address 1: 1100 WAYNE STREET
Address 2: SUITE 4001

City: TROY
Zip Code: 45373
County: MIAM

Contact: LAURA FERRELL
Title:
Phone: 9373320021
FAX: 9377789696

Vendor: 10293

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012