Provider Demographics
NPI:1518388297
Name:ROSSMORE ELDERLY CARE
Entity Type:Organization
Organization Name:ROSSMORE ELDERLY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MALEYKI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:870-494-6607
Mailing Address - Street 1:254 LANEY DR
Mailing Address - Street 2:
Mailing Address - City:FORREST CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72335-2336
Mailing Address - Country:US
Mailing Address - Phone:870-494-6607
Mailing Address - Fax:870-339-3440
Practice Address - Street 1:254 LANEY DR
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-2336
Practice Address - Country:US
Practice Address - Phone:870-494-6607
Practice Address - Fax:870-339-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health