MEDICARE: ALICIA JEVON DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1043852833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA JEVON DAVIS

Provider Business Mailing Address
First Line	:	5 SEVERANCE CIR
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1566
Country	:	US
Telephone Number	:	440-252-2882
Fax Number	:	440-261-4000

Provider Business Practice Location Address
First Line	:	5 SEVERANCE CIR
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1566
Country	:	US
Telephone Number	:	440-252-2882
Fax Number	:	440-261-4000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2019
Last Update Date	:	04/09/2026

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Directions to “ ALICIA JEVON DAVIS ” Practice Location

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