MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 12449
Change Report (if Any):

Short Name: OPTIONS CNTR

Long Name 1: OPTIONS CENTER INC
Long Name 2:

Address 1: 3898 LEE ROAD
Address 2:

City: CLEVELAND
Zip Code: 44128
County: CUYA

Contact: JAMES MINNIEWEATHER
Title: CEO
Phone: 2165418910
FAX: .

Vendor: 12449

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016