MEDICARE: PROFESSIONAL CAREGIVERS OF GREATER CLEVELAND

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1477027837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL CAREGIVERS OF GREATER CLEVELAND

Provider Business Mailing Address
First Line	:	6090 ROYALTON RD # 353
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-5104
Country	:	US
Telephone Number	:	440-308-7112
Fax Number	:	440-550-8727

Provider Business Practice Location Address
First Line	:	1332 SENECA BLVD
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-2416
Country	:	US
Telephone Number	:	440-308-7112
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED NURSE
Name	:	JANICE BURNEY
Credential	:	RN
Telephone Number	:	440-308-7112

Provider Enumeration Date	:	01/17/2019
Last Update Date	:	01/17/2019

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