MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 11000
Change Report (if Any):

Short Name: NEW VISIONS

Long Name 1: NEW VISIONS UNLIMITED INC
Long Name 2:

Address 1: 15105 BROADWAY STREET
Address 2:

City: MAPLE HEIGHTS
Zip Code: 44137
County: CUYA

Contact: KATHY KREJCIER
Title: CEO
Phone: 2168836700
FAX: 2168830050

Vendor: 11000

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/23/2012

File Produced: 14JUL2016