MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 13047
Change Report (if Any):

Short Name: NEW BEGINGS BH

Long Name 1: NEW BEGINNINGS BEHAVIORAL
Long Name 2: HEALTH LLC

Address 1: 108 NORTH THIRD STREET
Address 2: SUITE 201

City: IRONTON
Zip Code: 45638
County: LAWR

Contact: KAREN WADDLE
Title: OWNER
Phone: 7405339850
FAX: 7405339852

Vendor: 13047

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012