UPI (Provider ID): 10047
Change Report (if Any):

Short Name: PEP W BRIDGE DT

Long Name 1: POSITIVE EDUCATION PROGRAM
Long Name 2: WESTBRIDGE DAY TREATMENT CNTR

Address 1: 3185 WEST 41ST STREET
Address 2:

City: CLEVELAND
Zip Code: 44109
County: CUYA

Contact: DEBBIE ANDERSEN
Title:
Phone: 2166313633
FAX: 2166314322

Vendor: 10043

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016