UPI (Provider ID): 1425
Change Report (if Any):

Short Name: NOBLE BH

Long Name 1: NOBLE BEHAVIORAL HEALTH
Long Name 2: CHOICES

Address 1: 48 OLIVE STREET
Address 2:

City: CALDWELL
Zip Code: 437241356
County: NOBL

Contact: EMMA SLATER
Title: DIR
Phone: 7407325988
FAX: 7407324154

Vendor: 1425

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012