UPI (Provider ID): 8475
Change Report (if Any):

Short Name: HOPE HOUSE

Long Name 1: THE HOPE HOUSE
Long Name 2:

Address 1: 611 SOUTH ARCH AVENUE
Address 2:

City: ALLIANCE
Zip Code: 44601
County: STAR

Contact: ROGER RAMBAUD
Title: CLDIR
Phone: 3308299675
FAX: 3308218392

Vendor: 8475

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012