UPI (Provider ID): 6915
Change Report (if Any):

Short Name: LAURELWOOD-CHAG

Long Name 1: LAURELWOOD COUNSELING CENTER
Long Name 2: OF BEACHWOOD

Address 1: 23240 CHAGRIN BLVD
Address 2:

City: BEACHWOOD
Zip Code: 44122
County: CUYA

Contact: DIANE WETZIG
Title: DIR
Phone: 2165950500
FAX: 4405950547

Vendor: 10518

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016