Healthcare Provider Details

I. General information

NPI: 1861157885
Provider Name (Legal Business Name): GRANS HOMECARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17325 EUCLID AVE STE 3043
CLEVELAND OH
44112-1276
US

IV. Provider business mailing address

17325 EUCLID AVE STE 3043
CLEVELAND OH
44112-1276
US

V. Phone/Fax

Practice location:
  • Phone: 440-683-6633
  • Fax: 330-278-8845
Mailing address:
  • Phone: 440-683-6633
  • Fax: 330-278-8845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHATWAN DETRISE GIVENS
Title or Position: OWNER/CEO
Credential:
Phone: 216-394-1200