UPI (Provider ID): 10255
Change Report (if Any):

Short Name: BENJAMIN-CHAGRI

Long Name 1: BENJAMIN ROSE INSTITUTE
Long Name 2:

Address 1: 16500 CHAGRIN BOULEVARD
Address 2:

City: SHAKER HEIGHTS
Zip Code: 44120
County: CUYA

Contact: GAIL SELL
Title: ANAC
Phone: 2167918000
FAX: 2167918030

Vendor: 10256

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016