UPI (Provider ID): 10323
Change Report (if Any):

Short Name: APPLEWOOD-JONES

Long Name 1: APPLEWOOD CENTERS
Long Name 2: CARLOS AND MARY JONES CENTER

Address 1: 3518 WEST 25TH
Address 2:

City: CLEVELAND
Zip Code: 441091995
County: CUYA

Contact: JOHN SMOLIK
Title: MRES
Phone: 2167412241
FAX: 2165499821

Vendor: 10117

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016