UPI (Provider ID): 12467
Change Report (if Any):

Short Name: ADRIEL

Long Name 1: ADRIEL SCHOOL INC
Long Name 2:

Address 1: 414 NORTH DETROIT STREET
Address 2:

City: WEST LIBERTY
Zip Code: 43357
County: LOGA

Contact: LORI LEHMAN
Title: COMP
Phone: 9374650010
FAX: 9374658690

Vendor: 12467

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 04/09/2012

File Produced: 19MAY2012