Healthcare Provider Details

I. General information

NPI: 1134535529
Provider Name (Legal Business Name): ROSE TREE OT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 10/01/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5736 S. MACON ST.
ENGLEWOOD CO
80111
US

IV. Provider business mailing address

5736 S. MACON ST.
ENGLEWOOD CO
80111
US

V. Phone/Fax

Practice location:
  • Phone: 973-699-7111
  • Fax:
Mailing address:
  • Phone: 973-699-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number3023
License Number StateCO

VIII. Authorized Official

Name: DEBRA ROSENBAUM
Title or Position: PEDIATRIC OCCUPATIONAL THERAPIST
Credential: MS, OTR/L
Phone: 973-699-7111