Organization
ROSE LANE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS W. POTTS (NHA/PRESIDENT)
(330) 833-3174
Entity
Organization
Contact information
Practice address
5425 HIGH MILL AVE NW, MASSILLON, OH 44646-9005
(330) 833-3174
(330) 833-4216
Mailing address
5425 HIGH MILL AVE NW, MASSILLON, OH 44646-9005
(330) 833-3174
(330) 833-4216
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4070
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7500172
—
OH
Enumeration date
07/18/2005
Last updated
08/22/2020
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