UPI (Provider ID): 12622
Change Report (if Any):

Short Name: ABLE

Long Name 1: ASSET BUILDING AND LIFE SKILLS
Long Name 2: ENVIRONMENT INC

Address 1: 1000 12TH STREET NW
Address 2:

City: CANTON
Zip Code: 44703
County: STAR

Contact: THOMAS WEST
Title: EXDIR
Phone: 3304544686
FAX: 3304544697

Vendor: 12622

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012