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General NPI Number Information
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NPI Number | 1043766371
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Entity Type | Organization
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Legal Business Name | THE ROSE OF SHARON7,INC.
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 23931 WARREN RD
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City | SAN JACINTO
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State | CA
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Zip | 92582-3795
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Country | US
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Telephone | 951-591-0362
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Fax |
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Provider Business Mailing Address
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Address Line | 23931 WARREN ROAD
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City | SAN JACINTO
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State | CA
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Zip | 92582
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Country | US
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Telephone | 951-591-0362
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SHARON LYNETTE JACKSON
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Credential | M,S,
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Telephone | 951-591-0362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | CA
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