Healthcare Provider Details

I. General information

NPI: 1760301840
Provider Name (Legal Business Name): MRS. TRACY S GRETICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3171 W 142ND ST
CLEVELAND OH
44111-1406
US

IV. Provider business mailing address

3171 W 142ND ST
CLEVELAND OH
44111-1406
US

V. Phone/Fax

Practice location:
  • Phone: 216-385-3351
  • Fax:
Mailing address:
  • Phone: 216-385-3351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRS859359
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: