Provider Demographics
NPI:1033306360
Name:THE ROSALIE FOUNDATION LLC
Entity Type:Organization
Organization Name:THE ROSALIE FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANICKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-231-2826
Mailing Address - Street 1:2532 MAYBROOK CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-3296
Mailing Address - Country:US
Mailing Address - Phone:919-231-2826
Mailing Address - Fax:919-654-7770
Practice Address - Street 1:772 SAINT GEORGE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3757
Practice Address - Country:US
Practice Address - Phone:919-231-2826
Practice Address - Fax:919-654-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-691311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home