UPI (Provider ID): 6848
Change Report (if Any):

Short Name: MATT TALBOT INN

Long Name 1: CATHOLIC CHARITIES CORPORATION
Long Name 2: MATT TALBOT INN

Address 1: 2270 PROFESSOR AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44113
County: CUYA

Contact: RUTH ABEL
Title: BUSAD
Phone: 2167810288
FAX: 2167816270

Vendor: 10092

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/03/2013

File Produced: 14JUL2016