Individual
SHANNON N FELIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4545 W 170TH ST, CLEVELAND, OH 44135-2555
(216) 563-2309
Mailing address
4545 W 170TH ST, CLEVELAND, OH 44135-2555
(216) 563-2309
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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