Provider Demographics
NPI:1104565712
Name:ADAMS, JAUNEECE S
Entity type:Individual
Prefix:
First Name:JAUNEECE
Middle Name:S
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19400 NYACK CT
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-2734
Mailing Address - Country:US
Mailing Address - Phone:216-548-7217
Mailing Address - Fax:
Practice Address - Street 1:1657 CLIFFVIEW RD # 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1110
Practice Address - Country:US
Practice Address - Phone:216-548-7217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005752175T00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No253Z00000XAgenciesIn Home Supportive Care