PROVIDER
NAME
039801
PENTZ RUN YOUTH SERV
Unit
S/A
Srvc Cat
Service Desc
RU
FS
PA
Eff Date
Lap Date
Rate
Descr
Code
15550000
HOUSE SUP/SUP LIVING
5038
38
Y
7/1/2001
06/30/10
25.00
Hour
1555