Healthcare Provider Details

I. General information

NPI: 1992677272
Provider Name (Legal Business Name): PHD CARE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5676 MAYFIELD RD
LYNDHURST OH
44124-2916
US

IV. Provider business mailing address

5676 MAYFIELD RD
LYNDHURST OH
44124-2916
US

V. Phone/Fax

Practice location:
  • Phone: 216-482-7237
  • Fax:
Mailing address:
  • Phone: 216-482-7237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEBRA L BRAY
Title or Position: FNP-C
Credential: FNC-P
Phone: 216-482-7237