Provider Demographics
NPI:1861157885
Name:GRANS HOMECARE AGENCY
Entity type:Organization
Organization Name:GRANS HOMECARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHATWAN
Authorized Official - Middle Name:DETRISE
Authorized Official - Last Name:GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-394-1200
Mailing Address - Street 1:17325 EUCLID AVE STE 3043
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1276
Mailing Address - Country:US
Mailing Address - Phone:440-683-6633
Mailing Address - Fax:330-278-8845
Practice Address - Street 1:17325 EUCLID AVE STE 3043
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1276
Practice Address - Country:US
Practice Address - Phone:440-683-6633
Practice Address - Fax:330-278-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child