UPI (Provider ID): 12399
Change Report (if Any):

Short Name: COMPASS REC CNT

Long Name 1: COMPASS RECOVERY CENTER
Long Name 2:

Address 1: 246 SOUTH CHESTNUT STREET
Address 2:

City: RAVENNA
Zip Code: 44266
County: PORT

Contact: CHERYL ROTH
Title: DIR
Phone: 3302989391
FAX: 3302989392

Vendor: 12399

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 02/08/2012

File Produced: 19MAY2012