Healthcare Provider Details

I. General information

NPI: 1790037604
Provider Name (Legal Business Name): VENITA M PATTERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9775 ROCKSIDE RD STE 200
CLEVELAND OH
44125-6266
US

IV. Provider business mailing address

9775 ROCKSIDE RD STE 200
CLEVELAND OH
44125-6266
US

V. Phone/Fax

Practice location:
  • Phone: 216-526-2632
  • Fax:
Mailing address:
  • Phone: 216-526-2632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number401060910310
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: