Healthcare Provider Details

I. General information

NPI: 1891653689
Provider Name (Legal Business Name): CHANE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4696 W 125TH ST
CLEVELAND OH
44135-3702
US

IV. Provider business mailing address

4696 W 125TH ST
CLEVELAND OH
44135-3702
US

V. Phone/Fax

Practice location:
  • Phone: 216-855-3942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number630098190925
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: