UPI (Provider ID): 12856
Change Report (if Any):

Short Name: OPTIONS FAM/YTH

Long Name 1: OPTIONS FOR FAMILIES AND YOUTH
Long Name 2:

Address 1: 5131 WEST 140TH STREET
Address 2:

City: BROOK PARK
Zip Code: 44142
County: CUYA

Contact: MICHAEL D RUSH
Title: EXDIR
Phone: 2162677070
FAX: 2162677075

Vendor: 12856

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/17/2012

File Produced: 14JUL2016