Healthcare Provider Details

I. General information

NPI: 1477381705
Provider Name (Legal Business Name): ROSEBUD HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8409 AMBER BEACON CIR
MILLERSVILLE MD
21108-2051
US

IV. Provider business mailing address

8409 AMBER BEACON CIR
MILLERSVILLE MD
21108-2051
US

V. Phone/Fax

Practice location:
  • Phone: 703-587-5303
  • Fax:
Mailing address:
  • Phone: 703-587-5303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: FIRSTINA ROSE
Title or Position: CEO
Credential:
Phone: 703-587-5303