UPI (Provider ID): 12559
Change Report (if Any):

Short Name: COMPASS-CCRS

Long Name 1: COMPREHENSIVE ADDICTION
Long Name 2: SERVICES

Address 1: 2465 COLLINGWOOD BLVD
Address 2:

City: TOLEDO
Zip Code: 43620
County: LUCA

Contact: ROBERT STOKES
Title: EXDIR
Phone: 4192418827
FAX: 4193216833

Vendor: 12559

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/08/2011

File Produced: 19MAY2012