Healthcare Provider Details

I. General information

NPI: 1922929900
Provider Name (Legal Business Name): VIVIAN RICHMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11201 WADSWORTH AVE
CLEVELAND OH
44125-2271
US

IV. Provider business mailing address

11201 WADSWORTH AVE
CLEVELAND OH
44125-2271
US

V. Phone/Fax

Practice location:
  • Phone: 216-860-5559
  • Fax:
Mailing address:
  • Phone: 216-860-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: