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General NPI Number Information
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NPI Number | 1750941597
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Entity Type | Individual
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Provider Name | GINA N EATON CDCA QMHSMA CMSMA
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 3224 E 123RD ST
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City | CLEVELAND
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State | OH
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Zip | 44120-3850
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Country | US
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Telephone | 216-990-2143
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Fax |
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Provider Business Mailing Address
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Address Line | 3224 E 123RD ST
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City | CLEVELAND
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State | OH
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Zip | 44120-3850
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Country | US
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Telephone | 216-990-2143
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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 | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CDCA170113
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OH
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Taxonomy #8
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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