UPI (Provider ID): 10258
Change Report (if Any):

Short Name: CHRISTIAN-LORA

Long Name 1: CLEVELAND CHRISTIAN HOME INC
Long Name 2:

Address 1: 11401 LORAIN AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44111
County: CUYA

Contact: MIKE SCHERER
Title: DIR
Phone: 2166710977
FAX: 2169412080

Vendor: 10258

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/20/2011

File Produced: 14JUL2016