UPI (Provider ID): 1036
Change Report (if Any):

Short Name: UMADAOP-HAMILTO

Long Name 1: URBAN MINORITY ALCOHOLISM AND
Long Name 2: DRUG ABUSE OUTREACH PROGRAM

Address 1: 3021 VERNON PLACE
Address 2:

City: CINCINNATI
Zip Code: 45219
County: HAMI

Contact: MICHAEL LANGFORD
Title: EX DR
Phone: 5135417099
FAX: 5135419089

Vendor: 1036

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/30/2012

File Produced: 19MAY2012