UPI (Provider ID): 10361
Change Report (if Any):

Short Name: ACHIEV CTR-LAKE

Long Name 1: ACHIEVEMENT CENTERS
Long Name 2: FOR CHILDREN

Address 1: 14587 MADISON AVENUE
Address 2:

City: LAKEWOOD
Zip Code: 44107
County: CUYA

Contact: PATRICIA NOBLE
Title: CFO
Phone: 2167957100
FAX: 2167950615

Vendor: 10360

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016