UPI (Provider ID): 1471
Change Report (if Any):

Short Name: SHAWNEE MH

Long Name 1: SHAWNEE MENTAL HEALTH CENTER
Long Name 2:

Address 1: 901 WASHINGTON STREET
Address 2:

City: PORTSMOUTH
Zip Code: 45662
County: SCIO

Contact: DEBBIE DANILE
Title:
Phone: 7403547702
FAX: 7403531662

Vendor: 1471

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/05/2012

File Produced: 19MAY2012