UPI (Provider ID): 7116
Change Report (if Any):

Short Name: PSYCH & PSYCH

Long Name 1: PSYCHIATRIC AND PSYCHOLOGICAL
Long Name 2: SERVICES

Address 1: 750 SOUTH ABBE ROAD
Address 2:

City: ELYRIA
Zip Code: 44035
County: LORA

Contact: CINDY SABO
Title: OFFMG
Phone: 4403235121
FAX: 4403235134

Vendor: 7116

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/25/2012

File Produced: 19MAY2012