Provider Demographics
NPI:1679260186
Name:TATE, SYVONNA (HOME HEALTH SERVICE)
Entity type:Individual
Prefix:
First Name:SYVONNA
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:HOME HEALTH SERVICE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12705 DOVE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-4409
Mailing Address - Country:US
Mailing Address - Phone:216-825-0301
Mailing Address - Fax:
Practice Address - Street 1:12705 DOVE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-4409
Practice Address - Country:US
Practice Address - Phone:216-825-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1295HHN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health