Provider Demographics
NPI:1912704743
Name:ROSS HOME SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:ROSS HOME SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:402-616-2105
Mailing Address - Street 1:8207 BOWIE DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-1525
Mailing Address - Country:US
Mailing Address - Phone:402-616-2105
Mailing Address - Fax:
Practice Address - Street 1:8207 BOWIE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-1525
Practice Address - Country:US
Practice Address - Phone:402-616-2105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health