UPI (Provider ID): 13317
Change Report (if Any):

Short Name: MATT TALBOT MEN

Long Name 1: CATHOLIC CHARITIES CORPORATION
Long Name 2: MATT TALBOT FOR RECOVERY MEN

Address 1: 6735 STATE ROAD
Address 2:

City: PARMA
Zip Code: 44134
County: CUYA

Contact: TERRY MORRIS
Title: DIR
Phone: 4403453020
FAX: 1103453019

Vendor: 10092

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/03/2013

File Produced: 14JUL2016