MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 11226
Change Report (if Any):

Short Name: COMM ASMNT-EUCL

Long Name 1: COMMUNITY ASSESSMENT AND
Long Name 2: TREATMENT SERVICES

Address 1: 5000 EUCLID AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44103
County: CUYA

Contact: ROXANNE WALLACE
Title: CFO
Phone: 2164313800
FAX: 2164269813

Vendor: 6663

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016