MEDICARE: CYNNAIRIA CAVER

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	172V00000X	Community Health Worker
3	175T00000X	Peer Specialist
4	332B00000X	Durable Medical Equipment & Medical Supplies	1957161	OH
5	171400000X	Health & Wellness Coach	3629224	OH

General Provider Information

NPI Number	:	1639598428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNNAIRIA CAVER

Provider Business Mailing Address
First Line	:	2180 JACKSON BLVD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3009
Country	:	US
Telephone Number	:	216-347-8866
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 FAIRMOUNT BLVD STE C
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3177
Country	:	US
Telephone Number	:	216-347-8866
Fax Number	:

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

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	07/12/2023

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Directions to “ CYNNAIRIA CAVER ” Practice Location

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