UPI (Provider ID): 10633
Change Report (if Any):

Short Name: BELLEFAIRE-BUCK

Long Name 1: BELLEFAIRE JEWISH CHILDRENS
Long Name 2: BUREAU

Address 1: 11532 BUCKEYE AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44120
County: CUYA

Contact: BRIAN KELLY
Title: CONT
Phone: 2169322800
FAX: 2169326704

Vendor: 2447

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016