Healthcare Provider Details

I. General information

NPI: 1871198234
Provider Name (Legal Business Name): ROSE HOME IMPROVEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 HENLEY DEEMER RD
MC DERMOTT OH
45652-9055
US

IV. Provider business mailing address

4208 HENLEY DEEMER RD
MC DERMOTT OH
45652-9055
US

V. Phone/Fax

Practice location:
  • Phone: 740-259-4898
  • Fax:
Mailing address:
  • Phone: 740-259-4898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: ERICA ROSE
Title or Position: OWNER
Credential:
Phone: 740-259-4898