UPI (Provider ID): 12891
Change Report (if Any):

Short Name: BOYS/GIRLS CLUB

Long Name 1: MARION YOUTH DEVELOPMENT COUN
Long Name 2: BOYS AND GIRLS CLUB OF MARION

Address 1: 370 EAST MARK STREET
Address 2:

City: MARION
Zip Code: 43302
County: MARI

Contact: CAROL DIMOFF
Title: DIR
Phone: 7403873462
FAX: 7403875518

Vendor: 12891

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012