UPI (Provider ID): 12343
Change Report (if Any):

Short Name: LAURELWOOD-MENT

Long Name 1: LAURELWOOD COUNSELING CENTER
Long Name 2: OF MENTOR

Address 1: 7060 WAYSIDE DRIVE
Address 2:

City: MENTOR
Zip Code: 44060
County: LAKE

Contact: JAMES HUTCHINSON
Title: CFO
Phone: 4406398989
FAX: .

Vendor: 12342

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016