UPI (Provider ID): 10043
Change Report (if Any):

Short Name: PEP POS ED PROG

Long Name 1: POSITIVE EDUCATION PROGRAM
Long Name 2:

Address 1: 3100 EUCLID AVENUE
Address 2:

City: CLEVELAND
Zip Code: 441152508
County: CUYA

Contact: CLAUDIA LANN VALORE
Title:
Phone: 2162310400
FAX: 2163617774

Vendor: 10043

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/19/2011

File Produced: 14JUL2016