UPI (Provider ID): 10637
Change Report (if Any):

Short Name: BEREA-ST CLAIR

Long Name 1: CLEVELAND CARES GLENVILLE
Long Name 2:

Address 1: 12212 ST CLAIR AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44108
County: CUYA

Contact: JOHN CADDY
Title:
Phone: 4402342006
FAX: 4402348319

Vendor: 6871

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016