Provider Demographics
NPI:1841614807
Name:SHECONNA L DANIELS
Entity Type:Organization
Organization Name:SHECONNA L DANIELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STNA
Authorized Official - Prefix:
Authorized Official - First Name:SHECONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-370-0256
Mailing Address - Street 1:24370 GARDEN DR
Mailing Address - Street 2:APT 1206
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-2466
Mailing Address - Country:US
Mailing Address - Phone:216-370-0256
Mailing Address - Fax:
Practice Address - Street 1:24370 GARDEN DR
Practice Address - Street 2:APT 1206
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-2466
Practice Address - Country:US
Practice Address - Phone:216-370-0256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401432270812311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home