UPI (Provider ID): 10051
Change Report (if Any):

Short Name: PEP EARLY INT W

Long Name 1: POSITIVE EDUCATION PROGRAM
Long Name 2: EARLY INTERVENTION CENTER WEST

Address 1: 2357 TREMONT AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44113
County: CUYA

Contact: BILLIE NAVOJOSKY
Title:
Phone: 2165749689
FAX: 2169419950

Vendor: 10043

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016