Provider Demographics
NPI:1265279442
Name:ROSS RESIDENTIAL HOME
Entity type:Organization
Organization Name:ROSS RESIDENTIAL HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FARR-HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-254-2689
Mailing Address - Street 1:864 S HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-1044
Mailing Address - Country:US
Mailing Address - Phone:614-254-2689
Mailing Address - Fax:
Practice Address - Street 1:1983 FAIRWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1608
Practice Address - Country:US
Practice Address - Phone:614-254-2689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management