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General NPI Number Information
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NPI Number | 1659264893
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Entity Type | Individual
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Provider Name | SHEENA SHONTAE SOMERVILLE
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Gender | Female
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1673 ELBERON AVE
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City | EAST CLEVELAND
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State | OH
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Zip | 44112-4405
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Country | US
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Telephone | 216-618-0518
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Fax |
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Provider Business Mailing Address
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Address Line | 1673 ELBERON AVE
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City | EAST CLEVELAND
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State | OH
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Zip | 44112-4405
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Country | US
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Telephone | 216-618-0518
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2964322
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License Number State | OH
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