UPI (Provider ID): 10584
Change Report (if Any):

Short Name: WSIDE ECUMENICL

Long Name 1: WEST SIDE ECUMENICAL MINISTRY
Long Name 2:

Address 1: 5209 DETROIT AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44102
County: CUYA

Contact: DAVID FILMER
Title: DRFIN
Phone: 2166512037
FAX: 2166514145

Vendor: 10584

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/10/2011

File Produced: 14JUL2016