MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 6891
Change Report (if Any):

Short Name: CATH SOC-E 24TH

Long Name 1: CATHOLIC CHARITIES SERVICES
Long Name 2: CORP DEPAUL FAMILY CENTER

Address 1: 2320 EAST 24TH STREET
Address 2:

City: CLEVELAND
Zip Code: 44115
County: CUYA

Contact: DARRLY MASON
Title:
Phone: 2166870000
FAX: 2166870403

Vendor: 10092

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016