Provider Demographics
NPI:1053518910
Name:ROSS COUNTY COMMITTEE FOR ELDERLY, INC.
Entity type:Organization
Organization Name:ROSS COUNTY COMMITTEE FOR ELDERLY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-773-3544
Mailing Address - Street 1:1824 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1036
Mailing Address - Country:US
Mailing Address - Phone:740-773-3544
Mailing Address - Fax:740-773-4730
Practice Address - Street 1:1824 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1036
Practice Address - Country:US
Practice Address - Phone:740-773-3544
Practice Address - Fax:740-773-4730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0832120Medicaid