MEDICARE: LUCIANA M. BLACK

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	372600000X	Adult Companion		OH
2	261QA0600X	Adult Day Care Clinic/Center		OH

General Provider Information

NPI Number	:	1467304303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCIANA M. BLACK

Provider Business Mailing Address
First Line	:	16707 ELDAMERE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-1513
Country	:	US
Telephone Number	:	216-609-8238
Fax Number	:

Provider Business Practice Location Address
First Line	:	16707 ELDAMERE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-1513
Country	:	US
Telephone Number	:	216-609-8238
Fax Number	:

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

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/13/2026

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