MEDICARE: CHANE HARRIS

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	251J00000X	Nursing Care Agency	630098190925	OH

General Provider Information

NPI Number	:	1891653689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANE HARRIS

Provider Business Mailing Address
First Line	:	4696 W 125TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44135-3702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4696 W 125TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44135-3702
Country	:	US
Telephone Number	:	216-855-3942
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ CHANE HARRIS ” Practice Location

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