=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518729565
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TENACITY HEALTH SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2024
-----------------------------------------------------
Last Update Date | 01/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4403 SAINT CLAIR AVE STE 1.03
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44103-1125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-254-7062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4865 PEARL RD
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44109-5138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-254-7062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOO
-----------------------------------------------------
Name | ERIC GRIFFIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-254-7062
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------