MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 11178
Change Report (if Any):

Short Name: ACHIEV CTR-CHEE

Long Name 1: ACHIEVEMENT CENTERS FOR
Long Name 2: CHILDREN

Address 1: 15000 CHEERFUL LANE
Address 2:

City: STRONGSVILLE
Zip Code: 441365420
County: CUYA

Contact: RACHEL LEVTHAEUSER
Title: QAMGR
Phone: 4402386200
FAX: 4402381858

Vendor: 10360

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016