Healthcare Provider Details

I. General information

NPI: 1023936192
Provider Name (Legal Business Name): DEBORAH MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1058 E 79TH ST
CLEVELAND OH
44103-2116
US

IV. Provider business mailing address

1058 E 79TH ST
CLEVELAND OH
44103-2116
US

V. Phone/Fax

Practice location:
  • Phone: 216-703-3877
  • Fax:
Mailing address:
  • Phone: 216-703-3877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: