MEDICARE: CHRISTIAN ROSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		MI

General Provider Information

NPI Number	:	1023950037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN ROSE

Provider Business Mailing Address
First Line	:	30032 OAKWOOD ST
Second Line	:
City	:	INKSTER
State	:	MI
Zip	:	48141-1559
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8231 HUNTINGTON ST
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-1643
Country	:	US
Telephone Number	:	248-943-8295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “ CHRISTIAN ROSE ” Practice Location

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