UPI (Provider ID): 3458
Change Report (if Any):

Short Name: NEIGHBOR-MENTOR

Long Name 1: NEIGHBORING
Long Name 2:

Address 1: 5930 HEISLEY ROAD
Address 2:

City: MENTOR
Zip Code: 440601834
County: LAKE

Contact: MARILYN PICKETT
Title: CFO
Phone: 4403549924
FAX: 4403545808

Vendor: 3458

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/18/2011

File Produced: 19MAY2012