UPI (Provider ID): 12673
Change Report (if Any):

Short Name: NEW DIREC-DAISY

Long Name 1: NEW DIRECTIONS
Long Name 2:

Address 1: 2710 DAISY AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44109
County: CUYA

Contact: MICHAEL MATONEY
Title: CEO
Phone: 2165910324
FAX: 2168511243

Vendor: 1119

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/07/2011

File Produced: 14JUL2016