UPI (Provider ID): 10615
Change Report (if Any):

Short Name: WYOMING YOUTH

Long Name 1: WYOMING YOUTH SERVICES BUREAU
Long Name 2:

Address 1: 800 OAK AVENUE
Address 2:

City: WYOMING
Zip Code: 45215
County: HAMI

Contact: VICKIE CIOTTI
Title: EXDIR
Phone: 5138212428
FAX: 5138213707

Vendor: 10615

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/14/2011

File Produced: 19MAY2012