MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10473
Change Report (if Any):

Short Name: QUEST-SMITH HAL

Long Name 1: QUEST RECOVERY AND PREVENTION
Long Name 2: SERVICES

Address 1: 1680 NAVE ROAD SE SMITH HALL
Address 2:

City: MASSILLON
Zip Code: 44646
County: STAR

Contact: JERRY SEAMAN
Title: CEO
Phone: 3308371883
FAX: 3308375603

Vendor: 1491

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012