Healthcare Provider Details

I. General information

NPI: 1295546174
Provider Name (Legal Business Name): ROSACARE MEDICAL AND BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 DANBURY DR
BOWIE MD
20721-3203
US

IV. Provider business mailing address

1014 DANBURY DR
BOWIE MD
20721-3203
US

V. Phone/Fax

Practice location:
  • Phone: 407-479-0934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BILAL PARVEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 346-220-3534