UPI (Provider ID): 6751
Change Report (if Any):

Short Name: CN FAM/CHL BRID

Long Name 1: CENTER FOR FAMILIES CHILDREN
Long Name 2: HISPANIC COUNSELING MENTAL HLT

Address 1: 4115 BRIDGE AVENUE SUITE 309
Address 2:

City: CLEVELAND
Zip Code: 44113
County: CUYA

Contact: JOHN HECKMAN
Title: FISC
Phone: 2166511860
FAX: 2166511862

Vendor: 8227

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016