Healthcare Provider Details

I. General information

NPI: 1992350706
Provider Name (Legal Business Name): ROSE MEADOW GARDEN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 BEDFORD ROAD
NEW BOSTON NH
03070
US

IV. Provider business mailing address

PO BOX 1450
NEW BOSTON NH
03070-1450
US

V. Phone/Fax

Practice location:
  • Phone: 603-487-3590
  • Fax: 603-487-3591
Mailing address:
  • Phone: 603-487-3590
  • Fax: 603-487-3591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. KYLA M. HALL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 603-487-3590