UPI (Provider ID): 3952
Change Report (if Any):

Short Name: SAMARITAN BH

Long Name 1: SAMARITAN BEHAVIORAL HEALTH
Long Name 2:

Address 1: 601 S EDWIN C MOSES BLVD
Address 2: FL 4 NW BLDG

City: DAYTON
Zip Code: 454081424
County: MONT

Contact: SUE MCGATHA
Title: DIR
Phone: 9372768333
FAX: 9372768269

Vendor: 11128

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/19/2012

File Produced: 19MAY2012