Healthcare Provider Details

I. General information

NPI: 1629956115
Provider Name (Legal Business Name): ROSE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2025
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 WINNIKEE AVE
POUGHKEEPSIE NY
12601-2762
US

IV. Provider business mailing address

1820 ROUTE 376 STE 5 #1044
POUGHKEEPSIE NY
12603
US

V. Phone/Fax

Practice location:
  • Phone: 877-283-3646
  • Fax:
Mailing address:
  • Phone: 877-283-3646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SHELLY ANN NADINE ROSE
Title or Position: OWNER
Credential:
Phone: 877-283-3646