UPI (Provider ID): 1882
Change Report (if Any):

Short Name: APPLESEED

Long Name 1: APPLESEED COMMUNITY MENTAL
Long Name 2: HEALTH CENTER

Address 1: 2233 ROCKY LANE
Address 2:

City: ASHLAND
Zip Code: 44805
County: ASHL

Contact: KAREN VONSTEIN
Title: FINSP
Phone: 4192813716
FAX: 4192814205

Vendor: 1882

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012