UPI (Provider ID): 12732
Change Report (if Any):

Short Name: EXCEL ACADEMY

Long Name 1: EXCEL ACADEMY
Long Name 2:

Address 1: 116 WEST CHURCH STREET
Address 2:

City: NEWARK
Zip Code: 43055
County: LICK

Contact: MARY THOMPSON
Title: DIR
Phone: 7403231102
FAX: 7403235821

Vendor: 12732

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012