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General NPI Number Information
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NPI Number | 1861216871
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Entity Type | Individual
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Provider Name | LEEANNA TERESA ARCHIE
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Gender | Female
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 1271 E 169TH ST
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City | CLEVELAND
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State | OH
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Zip | 44110-1565
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Country | US
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Telephone | 216-239-7159
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Fax |
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Provider Business Mailing Address
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Address Line | 1273 E 169TH ST
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City | CLEVELAND
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State | OH
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Zip | 44110-1565
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Country | US
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Telephone | 216-239-7159
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 602372370922
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 602372370922
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 602372370922
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 602372370922
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License Number State | OH
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