Organization
EARLEY & ROSS OF FAYETTE COUNTY L,LLC
Active
Other names
Wintersong Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM ROSS (ADMINISTRATOR)
(740) 335-1380
Entity
Organization
Contact information
Practice address
719 RAWLINGS ST, WASHINGTON COURT HOUSE, OH 43160-1517
(740) 335-1380
(740) 636-0643
Mailing address
719 RAWLINGS ST, WASHINGTON COURT HOUSE, OH 43160-1517
(740) 335-1380
(740) 636-0643
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861689465
FACILITY NPI
OH
05
—
2768189
—
OH
01
—
366262
MEDICARE PROVIDER NUMBER
OH
Enumeration date
09/27/2007
Last updated
06/21/2018
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