UPI (Provider ID): 10041
Change Report (if Any):

Short Name: CATH CHAR-WAYNE

Long Name 1: CATHOLIC CHARITIES SERVICES
Long Name 2: WAYNE COUNTY PROGRAM

Address 1: 521 BEALL AVENUE
Address 2:

City: WOOSTER
Zip Code: 44691
County: WAYN

Contact: ANITA MILLER
Title: EX DR
Phone: 3302627836
FAX: 3302622867

Vendor: 10092

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016