MEDICARE: FRANKLIN COUNTY RESIDENTIAL SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	2512507	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417165846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANKLIN COUNTY RESIDENTIAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	1021 CHECKREIN AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-1106
Country	:	US
Telephone Number	:	614-844-3800
Fax Number	:	614-844-5913

Provider Business Practice Location Address
First Line	:	2434 KIMBERLY WOODS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4290
Country	:	US
Telephone Number	:	614-844-3800
Fax Number	:	614-844-5913

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. ED HARPER
Credential	:
Telephone Number	:	614-844-3800

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	08/22/2020

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