UPI (Provider ID): 1281
Change Report (if Any):

Short Name: TALBERT ADULT

Long Name 1: TALBERT HOUSE
Long Name 2: ADULT SERVICES

Address 1: 4531 READING ROAD
Address 2:

City: CINCINNATI
Zip Code: 45229
County: HAMI

Contact: WILLIAM HOSTLER
Title: CFO
Phone: 5137517747
FAX: 5138725182

Vendor: 1249

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/29/2011

File Produced: 19MAY2012