UPI (Provider ID): 2379
Change Report (if Any):

Short Name: CHILDRENS REHAB

Long Name 1: CHILDRENS REHABILITATION
Long Name 2: CENTER

Address 1: 885 HOWLAND WILSON ROAD NE
Address 2:

City: WARREN
Zip Code: 44484
County: TRUM

Contact: ROBERT FOSTER
Title: DIR
Phone: 3308562107
FAX: 3308562107

Vendor: 2379

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012