UPI (Provider ID): 1399
Change Report (if Any):

Short Name: DAY-MONT BEHAV

Long Name 1: DAY MONT BEHAVIOR HEALTH CARE
Long Name 2:

Address 1: 1520 GERMANTOWN STREET
Address 2:

City: DAYTON
Zip Code: 454081399
County: MONT

Contact: GAYLE JOHNSON
Title: PRES
Phone: 9372228111
FAX: 9372223019

Vendor: 1399

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/20/2012

File Produced: 19MAY2012