MEDICARE: CLIFFORD JARRETT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	347C00000X	Private Vehicle
3	372600000X	Adult Companion
4	376J00000X	Homemaker
5	385H00000X	Respite Care

General Provider Information

NPI Number	:	1386461598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFFORD JARRETT

Provider Business Mailing Address
First Line	:	3819 CLEVELAND AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-2385
Country	:	US
Telephone Number	:	330-371-5670
Fax Number	:

Provider Business Practice Location Address
First Line	:	3819 CLEVELAND AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-2385
Country	:	US
Telephone Number	:	330-371-5670
Fax Number	:

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

Provider Enumeration Date	:	09/20/2024
Last Update Date	:	09/20/2024

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Directions to “ CLIFFORD JARRETT ” Practice Location

Language	Start Address	Practice Location

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