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General NPI Number Information
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NPI Number | 1922344464
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Entity Type | Organization
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Legal Business Name | LETICIA HARRIS
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 2469 E 127TH ST
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City | CLEVELAND
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State | OH
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Zip | 44120-1020
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Country | US
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Telephone | 216-319-2494
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Fax |
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Provider Business Mailing Address
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Address Line | 2469 E 127TH ST
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City | CLEVELAND
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State | OH
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Zip | 44120-1020
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MS. LETICIA HARRIS
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Credential |
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Telephone | 216-319-2494
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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 | ST766758
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License Number State | OH
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