Healthcare Provider Details

I. General information

NPI: 1871087098
Provider Name (Legal Business Name): HERS AND HIS HOMECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7735 GRANGER RD STE C
CLEVELAND OH
44125-4822
US

IV. Provider business mailing address

7735 GRANGER RD STE C
CLEVELAND OH
44125-4822
US

V. Phone/Fax

Practice location:
  • Phone: 216-650-8313
  • Fax:
Mailing address:
  • Phone: 216-650-8313
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LATIECE DAVIS
Title or Position: CEO
Credential:
Phone: 216-650-8313