Provider Demographics
NPI:1609876192
Name:ROSEWOOD NURSING CENTER LLC
Entity type:Organization
Organization Name:ROSEWOOD NURSING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:TUTERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:181-644-4090
Mailing Address - Street 1:534 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7336
Mailing Address - Country:US
Mailing Address - Phone:337-439-8338
Mailing Address - Fax:337-310-8268
Practice Address - Street 1:534 15TH ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7336
Practice Address - Country:US
Practice Address - Phone:337-439-8338
Practice Address - Fax:337-310-8268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA422314000000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1516325Medicaid
LA195422Medicare Oscar/Certification