UPI (Provider ID): 12481
Change Report (if Any):

Short Name: FAMILY AN YOUTH

Long Name 1: FAMILY AND YOUTH INSTITUTE
Long Name 2:

Address 1: 14 SANDALWOOD DRIVE
Address 2:

City: NEWARK
Zip Code: 43055
County: LICK

Contact: KENNETH LARIMORE
Title: ADMIN
Phone: 7407888850
FAX: 7407888851

Vendor: 12481

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012