Provider Demographics
NPI:1609652890
Name:ROSI C RANCH LLC
Entity Type:Organization
Organization Name:ROSI C RANCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:COLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-543-0145
Mailing Address - Street 1:1325 FLEMING FALLS RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-8702
Mailing Address - Country:US
Mailing Address - Phone:419-543-0145
Mailing Address - Fax:
Practice Address - Street 1:1325 FLEMING FALLS RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-8702
Practice Address - Country:US
Practice Address - Phone:419-543-0145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or Charitable