Provider Demographics
NPI:1942983812
Name:AKUCHU, JOEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:AKUCHU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 GRANADA BLVD APT 118
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-4816
Mailing Address - Country:US
Mailing Address - Phone:216-240-2563
Mailing Address - Fax:
Practice Address - Street 1:4501 GRANADA BLVD APT 118
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-4816
Practice Address - Country:US
Practice Address - Phone:216-240-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602700950823374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide