UPI (Provider ID): 8191
Change Report (if Any):

Short Name: BIG BR/SIS-LAKE

Long Name 1: BIG BROTHERS BIG SISTERS OF
Long Name 2: NORTHEAST OHIO

Address 1: 8 NORTH STATE STREET
Address 2: SUITE 360

City: PAINESVILLE
Zip Code: 44077
County: LAKE

Contact: TIM KEHRES
Title: DIR
Phone: 4403522526
FAX: 4403522580

Vendor: 8191

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012