MEDICARE: THE JOHN AND JOSEPHINE ROSE LIVING NETWORK FOUNDATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251300000X	Local Education Agency (LEA)
2	251B00000X	Case Management Agency
3	251E00000X	Home Health Agency
4	253Z00000X	In Home Supportive Care Agency
5	261QH0100X	Health Service Clinic/Center
6	332800000X	Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
7	343900000X	Non-emergency Medical Transport (VAN)
8	385H00000X	Respite Care
9	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	HHA-00001	OTHER	BANNER UFC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770239998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE JOHN AND JOSEPHINE ROSE LIVING NETWORK FOUNDATION

Provider Business Mailing Address
First Line	:	5541 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2209
Country	:	US
Telephone Number	:	520-704-8310
Fax Number	:	520-848-3611

Provider Business Practice Location Address
First Line	:	5541 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2209
Country	:	US
Telephone Number	:	520-704-8310
Fax Number	:	520-848-3611

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	JAMES JOSEPH ROSE
Credential	:
Telephone Number	:	520-204-7958

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	09/06/2022

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Directions to “THE JOHN AND JOSEPHINE ROSE LIVING NETWORK FOUNDATION ” Practice Location

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