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General NPI Number Information
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NPI Number | 1922136381
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Entity Type | Organization
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Legal Business Name | ROSE GARDEN
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6163 LEWIS AVE
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City | LONG BEACH
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State | CA
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Zip | 90805-3057
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Country | US
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Telephone | 562-423-7562
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Fax | 562-423-7562
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Provider Business Mailing Address
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Address Line | 6163 LEWIS AVE
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City | LONG BEACH
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State | CA
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Zip | 90805-3057
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Country | US
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Telephone | 562-423-7562
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Fax | 562-423-7562
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Authorized Official
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Title or Position | BUISNESS OWNER
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Name | MRS. MONICA CHAVEZ
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Credential |
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Telephone | 562-423-7562
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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 |
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License Number State | CA
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