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NPI Code Detail

MEDICARE: MARLENE HAIRSTON QMHS, CMS

MEDICARE: MARLENE HAIRSTON QMHS, CMS
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
1172V00000XCommunity Health Worker
2171M00000XCase Manager/Care Coordinator
3385H00000XRespite Care

General Provider Information

NPI Number : 1043953607
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLENE HAIRSTON QMHS, CMS
Provider Business Mailing Address
First Line : 434 EASTLAND RD
Second Line :
City : BEREA
State : OH
Zip : 44017-1217
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3500 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2641
Country : US
Telephone Number : 440-234-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2022
Last Update Date : 05/18/2026

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Directions to “ MARLENE HAIRSTON QMHS, CMS” Practice Location

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