Healthcare Provider Details

I. General information

NPI: 1851976450
Provider Name (Legal Business Name): SHANTELL CHERI LENNOX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2021
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27125 CAMERON AVE
EUCLID OH
44132-1717
US

IV. Provider business mailing address

27125 CAMERON AVE
EUCLID OH
44132-1717
US

V. Phone/Fax

Practice location:
  • Phone: 440-990-5227
  • Fax:
Mailing address:
  • Phone: 440-990-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: