UPI (Provider ID): 10386
Change Report (if Any):

Short Name: HB SUMM WOW CSN

Long Name 1: HB SUMMIT WITHOUT WALLS CSN
Long Name 2:

Address 1: 2321 SECOND STREET STE 102
Address 2:

City: CUYAHOGA FALLS
Zip Code: 44221
County: SUMM

Contact: KATHY OBERLIN
Title:
Phone: 3309237545
FAX: .

Vendor: 3275

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016