UPI (Provider ID): 1165
Change Report (if Any):

Short Name: PARKSIDE RECVRY

Long Name 1: PARKSIDE BEHAVIORAL HEALTHCARE
Long Name 2:

Address 1: 349 OLDE RIDENOUR ROAD
Address 2:

City: COLUMBUS
Zip Code: 43230
County: FRAN

Contact: DR ALVIN PELP
Title:
Phone: 6144712552
FAX: 6144710167

Vendor: 1165

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012