UPI (Provider ID): 11232
Change Report (if Any):

Short Name: CNTR BH HEALTH

Long Name 1: CENTER FOR BEHAVIORAL HEALTH
Long Name 2: CARE INC

Address 1: 725 BOARDMAN CANFIELD ROAD
Address 2: BLDG D

City: BOARDMAN
Zip Code: 44512
County: MAHO

Contact: LINDA KING
Title: CEO
Phone: 3307839690
FAX: 3307839693

Vendor: 11232

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012