MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10130
Change Report (if Any):

Short Name: CYO COMM SERV

Long Name 1: CYO AND COMMUNITY SERVICES
Long Name 2:

Address 1: 640 NORTH MAIN STREET
Address 2:

City: AKRON
Zip Code: 44310
County: SUMM

Contact: SARA LUCAS
Title: DOF
Phone: 3307627481
FAX: 3307627484

Vendor: 10130

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016