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General NPI Number Information
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NPI Number | 1922791318
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Entity Type | Individual
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Provider Name | MR. JOSEPH MITHELL
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Gender | Male
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 2671 BRAMBLEWOOD DR
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City | BROADVIEW HEIGHTS
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State | OH
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Zip | 44147-2003
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Country | US
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Telephone | 440-478-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 6719 BIG CREEK PKWY
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City | CLEVELAND
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State | OH
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Zip | 44130-2602
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Country | US
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Telephone | 440-478-6770
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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 | 2772405
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License Number State | OH
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