Healthcare Provider Details

I. General information

NPI: 1962884643
Provider Name (Legal Business Name): ROSEMARY CHILDREN'S SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 06/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 CLIFFSIDE DR
SAN DIMAS CA
91773-2957
US

IV. Provider business mailing address

677 CLIFFSIDE DR
SAN DIMAS CA
91773-2957
US

V. Phone/Fax

Practice location:
  • Phone: 626-403-2277
  • Fax:
Mailing address:
  • Phone: 626-403-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JANA TREW
Title or Position: REGIONAL EXECUTIVE DIRECTOR
Credential:
Phone: 626-844-3033