UPI (Provider ID): 9019
Change Report (if Any):

Short Name: CATH CHAR-25TH

Long Name 1: CATHOLIC CHARITIES CORPORATION
Long Name 2:

Address 1: 2012 WEST 25TH ST SUITE 507
Address 2:

City: CLEVELAND
Zip Code: 441134131
County: CUYA

Contact: RUTH ABEL
Title: BUSAD
Phone: 2166962197
FAX: 2166962088

Vendor: 10092

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/03/2013

File Produced: 14JUL2016