Healthcare Provider Details

I. General information

NPI: 1568290542
Provider Name (Legal Business Name): ASHLEY DIANA FREEMAN C-CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14016 REXWOOD AVE
CLEVELAND OH
44105-6426
US

IV. Provider business mailing address

14016 REXWOOD AVE
CLEVELAND OH
44105-6426
US

V. Phone/Fax

Practice location:
  • Phone: 216-773-5080
  • Fax:
Mailing address:
  • Phone: 216-773-5080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number400508310605
License Number StateOH
# 7
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberCHW.002595
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: