MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 12772
Change Report (if Any):

Short Name: REC RES-CENTER

Long Name 1: RECOVERY RESOURCES
Long Name 2:

Address 1: 20525 CENTER RIDGE ROAD
Address 2: SUITE 518

City: ROCKY RIVER
Zip Code: 44116
County: CUYA

Contact: GORDON HEWITT
Title: CFO
Phone: 2164314131
FAX: 2164314151

Vendor: 6973

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016