UPI (Provider ID): 1057
Change Report (if Any):

Short Name: COUNSEL-CRAW

Long Name 1: COMMUNITY COUNSELING SERVICES
Long Name 2:

Address 1: 2458 STETZER ROAD
Address 2:

City: BUCYRUS
Zip Code: 44820
County: CRAW

Contact: THOMAS SACCENTI
Title: CEO
Phone: 4195622000
FAX: 4195621296

Vendor: 1057

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/27/2011

File Produced: 19MAY2012