Provider Demographics
NPI:1053308726
Name:JADA, INC
Entity Type:Organization
Organization Name:JADA, INC
Other - Org Name:ROSE GARDEN NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP.OFFICE ADMINISTRATIVE ASSIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-526-0124
Mailing Address - Street 1:303 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-2045
Mailing Address - Country:US
Mailing Address - Phone:740-393-2046
Mailing Address - Fax:740-309-5140
Practice Address - Street 1:303 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-2045
Practice Address - Country:US
Practice Address - Phone:740-393-2046
Practice Address - Fax:740-309-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-28
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility