UPI (Provider ID): 1381
Change Report (if Any):

Short Name: COUNSEL-MARI

Long Name 1: MARION AREA COUNSELING CENTER
Long Name 2:

Address 1: 320 EXECUTIVE DRIVE
Address 2:

City: MARION
Zip Code: 43302
County: MARI

Contact: BEVERLY YOUNG
Title: EX DR
Phone: 7403875210
FAX: 7403823713

Vendor: 1381

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/06/2012

File Produced: 19MAY2012