UPI (Provider ID): 10415
Change Report (if Any):

Short Name: BELLEFAIRE-LORA

Long Name 1: BELLEFAIRE JEWISH CHILDRENS
Long Name 2: BUREAU OF LORAIN COUNTY

Address 1: 347 MIDWAY BLVD
Address 2: SUITE 200

City: ELYRIA
Zip Code: 44035
County: LORA

Contact: TAMARA IWASZKIW
Title:
Phone: 4403245701
FAX: 4403249978

Vendor: 2447

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016