MEDICARE: ROSE GARDEN

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	311ZA0620X	Adult Care Home Facility		CA

General Provider Information

NPI Number	:	1922136381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSE GARDEN

Provider Business Mailing Address
First Line	:	6163 LEWIS AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-3057
Country	:	US
Telephone Number	:	562-423-7562
Fax Number	:	562-423-7562

Provider Business Practice Location Address
First Line	:	6163 LEWIS AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-3057
Country	:	US
Telephone Number	:	562-423-7562
Fax Number	:	562-423-7562

Authorized Official
Title or Position	:	BUISNESS OWNER
Name	:	MRS. MONICA CHAVEZ
Credential	:
Telephone Number	:	562-423-7562

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	08/22/2020

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Directions to “ROSE GARDEN ” Practice Location

Language	Start Address	Practice Location

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