UPI (Provider ID): 1095
Change Report (if Any):

Short Name: UMADAOP-COLUMBS

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

Address 1: 98 HAMILTON PARK
Address 2: SUITE 1F

City: COLUMBUS
Zip Code: 43203
County: FRAN

Contact: ALRED RAY
Title: EXDIR
Phone: 6144691223
FAX: 6144697544

Vendor: 1095

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012