UPI (Provider ID): 12765
Change Report (if Any):

Short Name: CATH CHAR-LORA

Long Name 1: CATHOLIC CHARITIES OF
Long Name 2: LORAIN COUNTY

Address 1: 628 POPLAR STREET
Address 2:

City: ELYRIA
Zip Code: 44035
County: LORA

Contact: MISSY BECK
Title: ACCT
Phone: 4403661106
FAX: 4403665645

Vendor: 10092

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/07/2013

File Produced: 14JUL2016