UPI (Provider ID): 11172
Change Report (if Any):

Short Name: SHELBY CNTY CNS

Long Name 1: SHELBY COUNTY COUNSELING
Long Name 2: CENTER INC

Address 1: 1101 NORTH VANDEMARK ROAD
Address 2:

City: SIDNEY
Zip Code: 45365
County: SHEL

Contact: KEN WARD
Title: EXDIR
Phone: 9374926970
FAX: 9374926971

Vendor: 11172

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/20/2011

File Produced: 19MAY2012