UPI (Provider ID): 6783
Change Report (if Any):

Short Name: TRAN LIVING

Long Name 1: TRANSITIONAL LIVING
Long Name 2:

Address 1: 2052 PRINCETON ROAD
Address 2:

City: HAMILTON
Zip Code: 45011
County: BUTL

Contact: MIKE BOLOGNA
Title:
Phone: 5138636383
FAX: 5138639882

Vendor: 6783

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/26/2012

File Produced: 19MAY2012