MEDICARE: JAMELIA CHERI CUNNINGHAM

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	385HR2055X	Child Mental Illness Respite Care

General Provider Information

NPI Number	:	1790560688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMELIA CHERI CUNNINGHAM

Provider Business Mailing Address
First Line	:	11811 SHAKER BLVD STE 204
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1927
Country	:	US
Telephone Number	:	216-266-7210
Fax Number	:

Provider Business Practice Location Address
First Line	:	5311 NORTHFIELD RD
Second Line	:
City	:	BEDFORD
State	:	OH
Zip	:	44146-1188
Country	:	US
Telephone Number	:	216-322-8667
Fax Number	:

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

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	08/29/2023

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