UPI (Provider ID): 12193
Change Report (if Any):

Short Name: FRIENDSHIP CTR

Long Name 1: CANTON FRIENDSHIP CENTER
Long Name 2:

Address 1: 2200 CLEVELAND AVENUE NW
Address 2:

City: CANTON
Zip Code: 44709
County: STAR

Contact: LYNN MARKLEY
Title: EXDIR
Phone: 3304534275
FAX: 3304531445

Vendor: 10389

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/06/2012

File Produced: 19MAY2012