UPI (Provider ID): 6663
Change Report (if Any):

Short Name: COMM ASSESSMENT

Long Name 1: COMMUNITY ASSESSMENT AND
Long Name 2: TREATMENT SERVICES

Address 1: 8411 BROADWAY AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44105
County: CUYA

Contact: ROXANNE WALLACE
Title: CEO
Phone: 2164410200
FAX: 2164413176

Vendor: 6663

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/25/2014

File Produced: 14JUL2016