UPI (Provider ID): 6093
Change Report (if Any):

Short Name: SIX COUNTY-MUSK

Long Name 1: MUSKINGUM COUNSELING CENTER
Long Name 2:

Address 1: 2845 BELL STREET
Address 2:

City: ZANESVILLE
Zip Code: 43701
County: MUSK

Contact: JACKIE HOOVER
Title:
Phone: 7404549766
FAX: 7404554134

Vendor: 10187

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/08/2011

File Produced: 19MAY2012