Provider Demographics
NPI:1225447501
Name:RL ROSS ENTERPRISES LLC
Entity Type:Organization
Organization Name:RL ROSS ENTERPRISES LLC
Other - Org Name:A.C.R NOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-515-2628
Mailing Address - Street 1:11616 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-2366
Mailing Address - Country:US
Mailing Address - Phone:323-515-2628
Mailing Address - Fax:310-674-4909
Practice Address - Street 1:11616 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2366
Practice Address - Country:US
Practice Address - Phone:323-515-2628
Practice Address - Fax:310-674-4909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18585251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health