Healthcare Provider Details

I. General information

NPI: 1053616078
Provider Name (Legal Business Name): ROSE CARE INCORPORATED DBA BRIGHTSTAR OF IREDELL/ROWAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2011
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 N MAIN ST STE 214
MOORESVILLE NC
28115-2525
US

IV. Provider business mailing address

181 N MAIN ST STE 214
MOORESVILLE NC
28115-2525
US

V. Phone/Fax

Practice location:
  • Phone: 704-230-2273
  • Fax: 704-660-6134
Mailing address:
  • Phone: 704-230-2273
  • Fax: 704-660-6134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNC

VIII. Authorized Official

Name: DANIELLE MALBASA ROSE
Title or Position: DIRECTOR
Credential: M.D.
Phone: 704-591-0138