UPI (Provider ID): 11018
Change Report (if Any):

Short Name: YOUTH FORUM

Long Name 1: YOUTH FORUM INC
Long Name 2:

Address 1: 40 WEST SPRUCE STREET
Address 2:

City: COLUMBUS
Zip Code: 43215
County: FRAN

Contact: LYNNE MCWHERTER
Title: FINC
Phone: 6147608602
FAX: 6147608603

Vendor: 11018

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012