UPI (Provider ID): 13271
Change Report (if Any):

Short Name: NEW CREATION

Long Name 1: NEW CREATION COUNSELING CENTER
Long Name 2:

Address 1: 7695 SOUTH COUNTY ROAD 25A
Address 2:

City: TIPP CITY
Zip Code: 45371
County: MIAM

Contact: KITTY KINCAID
Title: ASSOC
Phone: 9376674678
FAX: 9376674963

Vendor: 60123

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 02/01/2012

File Produced: 19MAY2012