Healthcare Provider Details

I. General information

NPI: 1205462280
Provider Name (Legal Business Name): HARRIS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6779 MEMPHIS AVE STE 5
BROOKLYN OH
44144-2218
US

IV. Provider business mailing address

16000 SHIRLEY AVE
MAPLE HEIGHTS OH
44137-4617
US

V. Phone/Fax

Practice location:
  • Phone: 440-857-0034
  • Fax: 440-857-0014
Mailing address:
  • Phone: 216-704-4813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: NATASHA HARRIS
Title or Position: OWNER
Credential:
Phone: 216-704-4813