UPI (Provider ID): 1184
Change Report (if Any):

Short Name: HOUSE HOPE-ADRS

Long Name 1: HOUSE OF HOPE FOR ALCOHOLICS
Long Name 2:

Address 1: 825 DENNISON AVENUE
Address 2:

City: COLUMBUS
Zip Code: 43215
County: FRAN

Contact: ED SWEENEY
Title: CFO
Phone: 6142914691
FAX: 6142916323

Vendor: 1184

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 04/13/2012

File Produced: 19MAY2012