MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10544
Change Report (if Any):

Short Name: JEWISH-FAIRLAWN

Long Name 1: JEWISH FAMILY SERVICES
Long Name 2:

Address 1: 83 NORTH MILLER ROAD
Address 2:

City: FAIRLAWN
Zip Code: 44333
County: SUMM

Contact: THELMA BRETTSCHNEIDE
Title:
Phone: 3308673388
FAX: 3308673396

Vendor: 10544

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016