Organization
PHENOMENALLY YOURS HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORIA R SMITH (OWNER/CEO)
(216) 551-6494
Entity
Organization
Contact information
Practice address
964 BRUNSWICK RD, CLEVELAND HTS, OH 44112-2315
(216) 551-6494
Mailing address
964 BRUNSWICK RD, CLEVELAND HTS, OH 44112-2315
(216) 551-6494
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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