Healthcare Provider Details

I. General information

NPI: 1780983684
Provider Name (Legal Business Name): ROSE TENDER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19486 SHERWOOD ST
DETROIT MI
48234-2821
US

IV. Provider business mailing address

19486 SHERWOOD ST
DETROIT MI
48234-2821
US

V. Phone/Fax

Practice location:
  • Phone: 313-246-7883
  • Fax: 248-842-2899
Mailing address:
  • Phone: 313-246-7883
  • Fax: 248-824-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberR200585066270
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number2280551
License Number StateMI
# 9
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number2280551
License Number StateMI
# 10
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number2280551
License Number StateMI
# 11
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number2280551
License Number StateMI
# 12
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number2280551
License Number StateMI
# 13
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number2280551
License Number StateMI
# 14
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. MARQUIS ROSE I
Title or Position: FOUNDER
Credential: MR.
Phone: 313-246-7883