MEDICARE: RADIANT HORIZON FAMILY SERVICES

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	374U00000X	Home Health Aide
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1760220750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIANT HORIZON FAMILY SERVICES

Provider Business Mailing Address
First Line	:	15820 VAN AKEN BLVD APT 207
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-5369
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15820 VAN AKEN BLVD APT 207
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-5369
Country	:	US
Telephone Number	:	216-314-2280
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PARIS KEYON JOHNS
Credential	:
Telephone Number	:	216-314-2280

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	07/16/2024

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