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NPI Code Detail

MEDICARE: LATITIA HARDAWAY

MEDICARE:   LATITIA  HARDAWAY
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
1247000000XHealth Information Technician
2225C00000XRehabilitation Counselor
3251S00000XCommunity/Behavioral Health Agency
4171W00000XContractorOH
5385HR2060XChild Intellectual and/or Developmental Disabilities Respite Care
6374U00000XHome Health Aide
7174H00000XHealth Educator
8320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility
9385H00000XRespite Care

General Provider Information

NPI Number : 1679035265
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATITIA HARDAWAY
Provider Business Mailing Address
First Line : 3320 BEECHWOOD AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44118-1833
Country : US
Telephone Number : 216-309-8111
Fax Number :
Provider Business Practice Location Address
First Line : 3320 BEECHWOOD AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44118-1833
Country : US
Telephone Number : 216-309-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2019
Last Update Date : 03/11/2026

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Directions to “ LATITIA HARDAWAY ” Practice Location

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