MEDICARE: HEAVEN MORRIS MA

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	374U00000X	Home Health Aide
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1760136790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEAVEN MORRIS MA

Provider Business Mailing Address
First Line	:	2079 GREEN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44121-1109
Country	:	US
Telephone Number	:	216-338-7140
Fax Number	:

Provider Business Practice Location Address
First Line	:	2079 GREEN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44121-1109
Country	:	US
Telephone Number	:	216-338-7140
Fax Number	:

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

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	01/14/2025

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Directions to “ HEAVEN MORRIS MA” Practice Location

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