UPI (Provider ID): 6796
Change Report (if Any):

Short Name: GREATR CINCI BH

Long Name 1: GREATER CINCINNATI BEHAVIORAL
Long Name 2: HEALTH SERVICES

Address 1: 1322 EAST MCMILLAN STREET
Address 2:

City: CINCINNATI
Zip Code: 45206
County: HAMI

Contact: ROY HARDINSON
Title: DRFIN
Phone: 5133547000
FAX: 5133547115

Vendor: 6796

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/07/2011

File Produced: 19MAY2012