MEDICARE: ROSEWOOD 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	314000000X	Skilled Nursing Facility	4152304N	NY

General Provider Information

NPI Number	:	1245677533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSEWOOD CARE, LLC

Provider Business Mailing Address
First Line	:	284 TROY RD
Second Line	:
City	:	RENSSELAER
State	:	NY
Zip	:	12144-9474
Country	:	US
Telephone Number	:	518-286-1621
Fax Number	:

Provider Business Practice Location Address
First Line	:	284 TROY RD
Second Line	:
City	:	RENSSELAER
State	:	NY
Zip	:	12144-9474
Country	:	US
Telephone Number	:	518-286-1621
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LOUIS GELLIS
Credential	:
Telephone Number	:	518-286-1621

Provider Enumeration Date	:	05/28/2013
Last Update Date	:	05/29/2013

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