MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 4618
Change Report (if Any):

Short Name: JEWISH F/S-BEAC

Long Name 1: JEWISH FAMILY SERVICE
Long Name 2: ASSOCIATION OF CLEVELAND OHIO

Address 1: 24075 COMMERCE PARK
Address 2: SUITE 200

City: BEACHWOOD
Zip Code: 44122
County: CUYA

Contact: MARIE MILLER
Title: BUSMG
Phone: 2163712600
FAX: 2162926313

Vendor: 1053

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/06/2011

File Produced: 14JUL2016