UPI (Provider ID): 2286
Change Report (if Any):

Short Name: REC RES-DETROIT

Long Name 1: RECOVERY RESOURCES
Long Name 2:

Address 1: 14805 DETROIT AVENUE
Address 2: SUITE 200

City: LAKEWOOD
Zip Code: 44107
County: CUYA

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

Vendor: 6973

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/27/2012

File Produced: 14JUL2016