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General NPI Number Information
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NPI Number | 1811000722
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Entity Type | Organization
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Legal Business Name | AMANA ROSE, LLC
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 700 N TOWN EAST BLVD SUITE 159
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City | MESQUITE
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State | TX
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Zip | 75150-4770
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Country | US
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Telephone | 972-686-4366
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Fax | 888-686-4372
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Provider Business Mailing Address
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Address Line | 700 N TOWN EAST BLVD SUITE 159
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City | MESQUITE
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State | TX
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Zip | 75150-4770
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Country | US
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Telephone | 972-686-4366
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Fax | 972-686-4372
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Authorized Official
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Title or Position | COO
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Name | MRS. ELIZABETH A VOSS
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Credential |
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Telephone | 972-686-4366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010601
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License Number State | TX
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