MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10497
Change Report (if Any):

Short Name: MHS HOMELESS-GL

Long Name 1: MENTAL HEALTH SERVICES FOR
Long Name 2: HOMELESS PERSONS INC

Address 1: 6128 GLASS AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44103
County: CUYA

Contact: DUANA KAYE
Title:
Phone: 2166236555
FAX: 2166236539

Vendor: 10097

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016