UPI (Provider ID): 1174
Change Report (if Any):

Short Name: UMADAOP-CLEVE

Long Name 1: THE CLEVELAND URBAN MINORITY
Long Name 2: ALCOHOLISM AND DRUG ABUSE

Address 1: OUTREACH PROGRAM
Address 2: 1215 EAST 79TH STREET

City: CLEVELAND
Zip Code: 44103
County: CUYA

Contact: JESSICA HORNE
Title: EX DR
Phone: 2163612040
FAX: 2163611856

Vendor: 1174

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016