UPI (Provider ID): 2549
Change Report (if Any):

Short Name: E SIDE IWO PRG

Long Name 1: EAST SIDE CATHOLIC SHELTER
Long Name 2: IWO SAN PROGRAM

Address 1: PO BOX 20177
Address 2:

City: CLEVELAND
Zip Code: 44120
County: CUYA

Contact: MICHELLE BURLEY KEY
Title:
Phone: 2162315556
FAX: 2162313993

Vendor: 6989

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016