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General NPI Number Information
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NPI Number | 1518388297
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Entity Type | Organization
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Legal Business Name | ROSSMORE ELDERLY CARE
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Dates
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Enumeration Date | 12/23/2013
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 254 LANEY DR
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City | FORREST CITY
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State | AR
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Zip | 72335-2336
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Country | US
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Telephone | 870-494-6607
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Fax | 870-339-3440
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Provider Business Mailing Address
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Address Line | 254 LANEY DR
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City | FORREST CITY
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State | AR
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Zip | 72335-2336
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Country | US
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Telephone | 870-494-6607
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Fax | 870-339-3440
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Authorized Official
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Title or Position | CEO
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Name | MALEYKI ROSS
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Credential | N.A.
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Telephone | 870-494-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | AR
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