UPI (Provider ID): 6828
Change Report (if Any):

Short Name: FORENSIC MH SER

Long Name 1: FORENSIC AND MENTAL HEALTH
Long Name 2: SERVICES INC

Address 1: 851 WALNUT STREET
Address 2:

City: HAMILTON
Zip Code: 45011
County: BUTL

Contact: STEVE YOUNG
Title:
Phone: 5138675866
FAX: 5138675875

Vendor: 6828

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/10/2012

File Produced: 19MAY2012