Healthcare Provider Details

I. General information

NPI: 1255097226
Provider Name (Legal Business Name): THE JOHN AND JOSEPHINE ROSE LIVING NETWORK FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2021
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5541 E GRANT RD
TUCSON AZ
85712-2209
US

IV. Provider business mailing address

5541 E GRANT RD
TUCSON AZ
85712-2209
US

V. Phone/Fax

Practice location:
  • Phone: 520-704-8310
  • Fax: 520-848-3611
Mailing address:
  • Phone: 520-704-8310
  • Fax: 520-848-3611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: JAMES JOSEPH ROSE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 520-204-7958