Provider Demographics
NPI:1366240467
Name:POTTS, MAKAYLA J
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:J
Last Name:POTTS
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 1:4220 COLONY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3143
Mailing Address - Country:US
Mailing Address - Phone:216-577-0733
Mailing Address - Fax:
Practice Address - Street 1:814 E 185TH ST STE 100
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-2775
Practice Address - Country:US
Practice Address - Phone:216-577-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care