UPI (Provider ID): 10470
Change Report (if Any):

Short Name: MALLORY CNTR

Long Name 1: MALLORY CENTER FOR COMMUNITY
Long Name 2: DEVELOPEMENT

Address 1: 3262 BEECKMAN STREET
Address 2:

City: CINCINNATI
Zip Code: 45223
County: HAMI

Contact: ALBERT BROWN
Title: EXDIR
Phone: 5135912255
FAX: 5135910005

Vendor: 10470

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012