Provider Demographics
NPI:1043963655
Name:ROSE GARDEN RESIDENCE, LLC.
Entity Type:Organization
Organization Name:ROSE GARDEN RESIDENCE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEMALI
Authorized Official - Middle Name:MENIKE
Authorized Official - Last Name:RAJAPAKSHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-328-0918
Mailing Address - Street 1:1822 ARCOLA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2831
Mailing Address - Country:US
Mailing Address - Phone:301-681-7950
Mailing Address - Fax:
Practice Address - Street 1:1822 ARCOLA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2831
Practice Address - Country:US
Practice Address - Phone:301-681-7950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility