UPI (Provider ID): 1422
Change Report (if Any):

Short Name: MUSKINGUM BH

Long Name 1: MUSKINGUM BEHAVIORAL HEALTH
Long Name 2:

Address 1: 575 HARDING ROAD
Address 2:

City: ZANESVILLE
Zip Code: 437011725
County: MUSK

Contact: STEVEN CARREL
Title: CEO
Phone: 7404541266
FAX: 7404547650

Vendor: 1422

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012