MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 1507
Change Report (if Any):

Short Name: TURNING PT-PAUL

Long Name 1: TURNING POINT OF PAULDING
Long Name 2: COUNTY INC

Address 1: 451 MCDONALD PIKE
Address 2:

City: PAULDING
Zip Code: 45879
County: PAUL

Contact: DEANA COUCH
Title: EXDIR
Phone: 4193995612
FAX: 4193995454

Vendor: 1507

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012