Provider Demographics
NPI:1902566722
Name:JONES, ROSHAWN
Entity type:Individual
Prefix:
First Name:ROSHAWN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 JUNCTION AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-4176
Mailing Address - Country:US
Mailing Address - Phone:313-720-7800
Mailing Address - Fax:
Practice Address - Street 1:801 JUNCTION AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-4176
Practice Address - Country:US
Practice Address - Phone:313-720-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No372600000XNursing Service Related ProvidersAdult Companion
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No253Z00000XAgenciesIn Home Supportive Care
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care