UPI (Provider ID): 12241
Change Report (if Any):

Short Name: A NEW BEGINNING

Long Name 1: A NEW BEGINNING SOBER LIVING
Long Name 2:

Address 1: 11402 AVON AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44105
County: CUYA

Contact: CHANCE BUTTS
Title: EXDIR
Phone: 2166416277
FAX: 2169914320

Vendor: 12241

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016