Provider Demographics
NPI:1447917166
Name:ROSEWOOD CARE HOME LLC
Entity type:Organization
Organization Name:ROSEWOOD CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUNXIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:YIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-938-6631
Mailing Address - Street 1:3707 W ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-2028
Mailing Address - Country:US
Mailing Address - Phone:602-938-6631
Mailing Address - Fax:602-298-9832
Practice Address - Street 1:3707 W ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-2028
Practice Address - Country:US
Practice Address - Phone:602-938-6631
Practice Address - Fax:602-298-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility