UPI (Provider ID): 2962
Change Report (if Any):

Short Name: TASC-CUYA

Long Name 1: CUYAHOGA COUNTY TASC
Long Name 2:

Address 1: 1276 WEST THIRD STREET
Address 2: SUITE 210

City: CLEVELAND
Zip Code: 44113
County: CUYA

Contact: STEVEN TERRY
Title: CEO
Phone: 2164437265
FAX: 2166986924

Vendor: 10342

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 10/20/2014

File Produced: 14JUL2016