=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861157885
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRANS HOMECARE AGENCY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2021
-----------------------------------------------------
Last Update Date | 10/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17325 EUCLID AVE STE 3043
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44112-1276
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-683-6633
-----------------------------------------------------
Fax | 330-278-8845
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17325 EUCLID AVE STE 3043
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44112-1276
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-683-6633
-----------------------------------------------------
Fax | 330-278-8845
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | SHATWAN DETRISE GIVENS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-394-1200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385HR2055X
-----------------------------------------------------
Taxonomy Name | Child Mental Illness Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 320800000X
-----------------------------------------------------
Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 385HR2050X
-----------------------------------------------------
Taxonomy Name | Respite Care Camp
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 322D00000X
-----------------------------------------------------
Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 385HR2065X
-----------------------------------------------------
Taxonomy Name | Child Physical Disabilities Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------