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General NPI Number Information
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NPI Number | 1306390562
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Entity Type | Organization
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Legal Business Name | ROSE SENIOR CARE
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5327 TIMUQUANA RD APT 197 5327 TIMUQUANA ROAD APT 197
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City | JACKSONVILLE
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State | FL
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Zip | 32210-8074
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Country | US
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Telephone | 904-586-7532
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Fax |
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Provider Business Mailing Address
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Address Line | 5327 TIMUQUANA RD APT 197
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City | JACKSONVILLE
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State | FL
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Zip | 32210-8074
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Country | US
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Telephone | 904-586-7532
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Fax |
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Authorized Official
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Title or Position | HOMEMAKER/COMPANIES
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Name | MRS. ROSE M STANLEY
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Credential |
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Telephone | 904-586-7532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | FL
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