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General NPI Number Information
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NPI Number | 1629977566
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Entity Type | Organization
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Legal Business Name | ROSEHAVEN PLACE ASSISTED LIVING, LLC
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 258 SW CAPAN AVENUE
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City | GREENVILLE
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State | FL
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Zip | 32331
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Country | US
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Telephone | 850-242-7044
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Fax | 850-242-7088
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Provider Business Mailing Address
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Address Line | 2534 MATTHEW DR
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City | VALDOSTA
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State | GA
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Zip | 31601-8555
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Country | US
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Telephone | 850-242-7044
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Fax | 850-242-7088
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DR. ROSE MARY MARTIN
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Credential | DNP,MSN, RN
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Telephone | 229-630-7634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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