Organization
FREEMAN RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA YVONNE ROSS LPN (LPN)
(330) 899-9044
Entity
Organization
Contact information
Practice address
3570 EXECUTIVE DR STE 106, UNIONTOWN, OH 44685-8712
(330) 899-9044
(330) 899-9055
Mailing address
3570 EXECUTIVE DR STE 106, UNIONTOWN, OH 44685-8712
(330) 899-9044
(330) 899-9055
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.045068.MEDS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN.045068.MEDS
OHIO LICENSE CENTER NURSING BOARD
OH
Enumeration date
11/07/2017
Last updated
11/07/2017
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