Individual
MR. JORDEN DENEIL BLAKELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OWNER
Contact information
Practice address
6805 MAYFIELD RD APT 606, MAYFIELD HEIGHTS, OH 44124-2252
(216) 801-5494
Mailing address
6805 MAYFIELD RD APT 606, MAYFIELD HEIGHTS, OH 44124-2252
(216) 801-5494
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92-0390919
HOMECARE
OH
Enumeration date
11/16/2022
Last updated
04/08/2025
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