UPI (Provider ID): 11197
Change Report (if Any):

Short Name: PARKSIDE WOODS

Long Name 1: PARKSIDE BEHAVIORAL HEALTHCARE
Long Name 2: ACQUISITION INC

Address 1: 349 OLDE RIDENOUR ROAD
Address 2:

City: GAHANNA
Zip Code: 43230
County: FRAN

Contact: KAREN COLE
Title:
Phone: 6144712552
FAX: 6144711067

Vendor: 11197

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012