MEDICARE: MAKAYLA J POTTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1366240467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKAYLA J POTTS

Provider Business Mailing Address
First Line	:	4220 COLONY RD
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-3143
Country	:	US
Telephone Number	:	216-577-0733
Fax Number	:

Provider Business Practice Location Address
First Line	:	814 E 185TH ST STE 100
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-2775
Country	:	US
Telephone Number	:	216-577-7333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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Directions to “ MAKAYLA J POTTS ” Practice Location

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