UPI (Provider ID): 10170
Change Report (if Any):

Short Name: CULTURAL AWRNSS

Long Name 1: CENTER FOR CULTURAL AWARENESS
Long Name 2:

Address 1: 140 JACKSON STREET FL 3
Address 2:

City: SANDUSKY
Zip Code: 44870
County: ERIE

Contact: ETHEL ROLDAN
Title: EX DR
Phone: 4196211117
FAX: 4196218089

Vendor: 10170

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012