Healthcare Provider Details

I. General information

NPI: 1487457719
Provider Name (Legal Business Name): HARRIS RESIDENTIAL HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13416 GRANNIS RD
GARFIELD HEIGHTS OH
44125-4422
US

IV. Provider business mailing address

3464 CRANDALL AVE
RICHFIELD OH
44286-9693
US

V. Phone/Fax

Practice location:
  • Phone: 216-704-4813
  • Fax:
Mailing address:
  • Phone: 216-704-4813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. NATASHA WILEY
Title or Position: OWNER/ CEO
Credential:
Phone: 216-704-4813