MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 1880
Change Report (if Any):

Short Name: DIRECTIONS YTH

Long Name 1: DIRECTIONS FOR YOUTH AND
Long Name 2: FAMILIES INC

Address 1: 1515 INDIANOLA AVENUE
Address 2:

City: COLUMBUS
Zip Code: 43201
County: FRAN

Contact: STEVE VOTAW
Title: CEO
Phone: 6142942661
FAX: 6142943247

Vendor: 1880

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/19/2011

File Produced: 19MAY2012