UPI (Provider ID): 12563
Change Report (if Any):

Short Name: COMPASS-SASI

Long Name 1: COMPREHENSIVE ADDICTION
Long Name 2: SERVICES

Address 1: 1916 NORTH 12TH STREET
Address 2:

City: TOLEDO
Zip Code: 43604
County: LUCA

Contact: CARROL PARKS
Title:
Phone: 4192418827
FAX: 4192431505

Vendor: 12559

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/13/2011

File Produced: 19MAY2012