Healthcare Provider Details

I. General information

NPI: 1881505246
Provider Name (Legal Business Name): AUGUSTA GRIGGS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3872 E 55TH ST
CLEVELAND OH
44105-3358
US

IV. Provider business mailing address

3872 E 55TH ST
CLEVELAND OH
44105-3358
US

V. Phone/Fax

Practice location:
  • Phone: 717-654-5489
  • Fax:
Mailing address:
  • Phone: 717-654-5489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: