Provider Demographics
NPI:1003283151
Name:KEEPING YOUR ROSE TIMELESS HOME CARE
Entity Type:Organization
Organization Name:KEEPING YOUR ROSE TIMELESS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCIAN
Authorized Official - Middle Name:CHAVETT
Authorized Official - Last Name:KNOTT
Authorized Official - Suffix:
Authorized Official - Credentials:HHA /APD
Authorized Official - Phone:813-284-8670
Mailing Address - Street 1:2010 E 148TH AVE APT 22
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-4601
Mailing Address - Country:US
Mailing Address - Phone:813-284-8670
Mailing Address - Fax:
Practice Address - Street 1:2010 E 148TH AVE APT 22
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-4601
Practice Address - Country:US
Practice Address - Phone:813-284-8670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27V215251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health