UPI (Provider ID): 10321
Change Report (if Any):

Short Name: APPLEWOOD-SOM

Long Name 1: APPLEWOOD CENTERS
Long Name 2:

Address 1: 730 SOM CENTER ROAD
Address 2: SUITE 100

City: MAYFIELD VILLAGE
Zip Code: 441432313
County: CUYA

Contact: RICHARD PAULSON
Title: CEO
Phone: 4404426447
FAX: 4404426113

Vendor: 10117

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016