UPI (Provider ID): 1214
Change Report (if Any):

Short Name: PREV CNCL OF OH

Long Name 1: PREVENTION COUNCIL OF CENTRAL
Long Name 2: OHIO

Address 1: 400 EAST MOUND STREET
Address 2: SUITE 100

City: COLUMBUS
Zip Code: 43215
County: FRAN

Contact: TRACI MASON
Title: EXDIR
Phone: 6142208572
FAX: 6147559159

Vendor: 1214

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012