UPI (Provider ID): 1186
Change Report (if Any):

Short Name: NORTH CMTY COUN

Long Name 1: NORTH COMMUNITY COUNSELING
Long Name 2: CENTERS INC

Address 1: 4897 KARL ROAD
Address 2:

City: COLUMBUS
Zip Code: 43229
County: FRAN

Contact: JOYCE SOUDER
Title: MG
Phone: 6148462588
FAX: 6148469759

Vendor: 1186

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/27/2011

File Produced: 19MAY2012