Healthcare Provider Details

I. General information

NPI: 1679006530
Provider Name (Legal Business Name): ROSE DREW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSE AMELIA AMARAL HOME CARE

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 KINGMAN ST
EAST TAUNTON MA
02718-1408
US

IV. Provider business mailing address

54 KINGMAN ST
EAST TAUNTON MA
02718-1408
US

V. Phone/Fax

Practice location:
  • Phone: 774-606-7078
  • Fax:
Mailing address:
  • Phone: 774-606-7078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224ZF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: