UPI (Provider ID): 10324
Change Report (if Any):

Short Name: LUTHERN MIN-104

Long Name 1: LUTHERAN METROPOLITAN
Long Name 2: MINISTRY

Address 1: 3020 WEST 104TH STREET
Address 2:

City: CLEVELAND
Zip Code: 44111
County: CUYA

Contact: CAROL FREDRICH
Title: DIR
Phone: 2166962714
FAX: 2166219008

Vendor: 1875

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016