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NPI Code Detail

MEDICARE: GRANS HOMECARE AGENCY

MEDICARE: GRANS HOMECARE AGENCY
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
1385HR2055XChild Mental Illness Respite Care
2320800000XMental Illness Community Based Residential Treatment Facility
3251S00000XCommunity/Behavioral Health Agency
4385HR2050XRespite Care Camp
5322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility
6385HR2065XChild Physical Disabilities Respite Care
7251E00000XHome Health Agency

General Provider Information

NPI Number : 1861157885
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANS HOMECARE AGENCY
Provider Business Mailing Address
First Line : 17325 EUCLID AVE STE 3043
Second Line :
City : CLEVELAND
State : OH
Zip : 44112-1276
Country : US
Telephone Number : 440-683-6633
Fax Number : 330-278-8845
Provider Business Practice Location Address
First Line : 17325 EUCLID AVE STE 3043
Second Line :
City : CLEVELAND
State : OH
Zip : 44112-1276
Country : US
Telephone Number : 440-683-6633
Fax Number : 330-278-8845
Authorized Official
Title or Position : OWNER/CEO
Name : SHATWAN DETRISE GIVENS
Credential :
Telephone Number : 216-394-1200
Provider Enumeration Date : 11/04/2021
Last Update Date : 10/07/2025

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Directions to “GRANS HOMECARE AGENCY ” Practice Location

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