Provider Demographics
NPI:1477027837
Name:PROFESSIONAL CAREGIVERS OF GREATER CLEVELAND
Entity Type:Organization
Organization Name:PROFESSIONAL CAREGIVERS OF GREATER CLEVELAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-308-7112
Mailing Address - Street 1:6090 ROYALTON RD # 353
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-5104
Mailing Address - Country:US
Mailing Address - Phone:440-308-7112
Mailing Address - Fax:440-550-8727
Practice Address - Street 1:1332 SENECA BLVD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2416
Practice Address - Country:US
Practice Address - Phone:440-308-7112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health