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General NPI Number Information
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NPI Number | 1386506095
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Entity Type | Organization
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Legal Business Name | ROSEGARDEN HEALTHCARE SERVICES
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 760 BROADWAY APT 506
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City | ALBANY
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State | NY
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Zip | 12207-2394
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Country | US
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Telephone | 518-227-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 760 BROADWAY APT 506
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City | ALBANY
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State | NY
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Zip | 12207-2394
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Country | US
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Telephone | 518-227-0850
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORETTA E KILLIKELLY
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Credential | RN
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Telephone | 518-227-0850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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