UPI (Provider ID): 10262
Change Report (if Any):

Short Name: BEREA-3416 PROS

Long Name 1: BEREA CHILDRENS HOME
Long Name 2:

Address 1: 3416 PROSPECT AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44112
County: CUYA

Contact: DAWN RIST
Title:
Phone: 2164268523
FAX: .

Vendor: 6871

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016