MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 13487
Change Report (if Any):

Short Name: REC RES-15320EU

Long Name 1: RECOVERY RESOURCES
Long Name 2:

Address 1: 1320 EUCLID AVENUE
Address 2: SHAW HIGH SCHOOL

City: EAST CLEVELAND
Zip Code: 441122806
County: CUYA

Contact: DIANE KENNEDY LANGE
Title: CFO
Phone: 2164314131
FAX: 2164314151

Vendor: 6973

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/24/2013

File Produced: 14JUL2016