MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 3118
Change Report (if Any):

Short Name: HELPLINE-DELA

Long Name 1: HELPLINE OF DELAWARE AND
Long Name 2: MORROW COUNTIES INC

Address 1: 11 NORTH FRANKLIN STREET
Address 2:

City: DELAWARE
Zip Code: 43015
County: DELA

Contact: SUSAN HANSON
Title: EX DR
Phone: 7403631835
FAX: 7403693316

Vendor: 3118

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012