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General NPI Number Information
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NPI Number | 1417323486
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Entity Type | Organization
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Legal Business Name | ROSEMARY HOME II
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 1828 SANTA ANA
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City | CLOVIS
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State | CA
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Zip | 93611-9208
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Country | US
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Telephone | 559-291-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 3354 GETTYSBURG AVE
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City | CLOVIS
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State | CA
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Zip | 93619-5208
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Country | US
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Telephone | 559-291-1800
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Fax | 559-291-1880
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CHANDRA G RAJ
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Credential |
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Telephone | 559-291-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 107200829
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License Number State | CA
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