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General NPI Number Information
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NPI Number | 1487134169
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Entity Type | Organization
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Legal Business Name | COSIVA HOME HEALTH
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 23334 WILLIAMS AVE
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City | EUCLID
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State | OH
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Zip | 44123-1525
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Country | US
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Telephone | 216-233-1820
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Fax | 216-472-8162
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Provider Business Mailing Address
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Address Line | 23334 WILLIAMS AVE
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City | EUCLID
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State | OH
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Zip | 44123-1525
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Country | US
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Telephone | 216-233-1820
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Fax | 216-472-8162
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Authorized Official
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Title or Position | EXECUTIVE
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Name | MS. SHEREE LAVETTE STARR
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Credential | RN
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Telephone | 216-233-1820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 318171
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License Number State | OH
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