Provider Demographics
NPI:1497191290
Name:ROSE RESIDENTIAL HEALTH SERVICES
Entity Type:Organization
Organization Name:ROSE RESIDENTIAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DWEH-NAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-290-4425
Mailing Address - Street 1:1290 E LONG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1945
Mailing Address - Country:US
Mailing Address - Phone:614-290-4425
Mailing Address - Fax:
Practice Address - Street 1:1290 E LONG ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1945
Practice Address - Country:US
Practice Address - Phone:614-290-4425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services