Provider Demographics
NPI:1093584682
Name:ROSS, CHAIS ROSHAI
Entity Type:Individual
Prefix:MISS
First Name:CHAIS
Middle Name:ROSHAI
Last Name:ROSS
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 1:7022 BLUEBIRD RD NW
Mailing Address - Street 2:
Mailing Address - City:EAST CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44730-9601
Mailing Address - Country:US
Mailing Address - Phone:330-265-6473
Mailing Address - Fax:
Practice Address - Street 1:7022 BLUEBIRD RD NW
Practice Address - Street 2:
Practice Address - City:EAST CANTON
Practice Address - State:OH
Practice Address - Zip Code:44730-9601
Practice Address - Country:US
Practice Address - Phone:330-265-6473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator