MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10406
Change Report (if Any):

Short Name: SPECT-SILSBY

Long Name 1: SPECTRUM OF SUPPORTIVE SERVICE
Long Name 2: SILSBY HOUSE

Address 1: 3364 SILSBY ROAD
Address 2:

City: CLEVELAND HEIGHTS
Zip Code: 44118
County: CUYA

Contact: STEPHEN MORSE
Title: CEO
Phone: 2169392065
FAX: 2169392075

Vendor: 10232

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016