UPI (Provider ID): 1068
Change Report (if Any):

Short Name: UMADAOP-TOLEDO

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

Address 1: 2447 NEBRASKA AVENUE
Address 2:

City: TOLEDO
Zip Code: 43607
County: LUCA

Contact: JOHN EDWARDS
Title: EX DR
Phone: 4192554444
FAX: 4195311596

Vendor: 1068

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/18/2011

File Produced: 19MAY2012