MEDICARE: ROSETTA'S HOME AND CARE LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1215646195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSETTA'S HOME AND CARE LLC.

Provider Business Mailing Address
First Line	:	415 WELCOME
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-8172
Country	:	US
Telephone Number	:	469-612-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 WELCOME
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-8172
Country	:	US
Telephone Number	:	469-612-2700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAREN TAITE
Credential	:
Telephone Number	:	469-612-2700

Provider Enumeration Date	:	11/18/2022
Last Update Date	:	02/22/2023

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