Provider Demographics
NPI:1093407991
Name:SINGH, SUKHPAL (ROSELYN'S CARE LLC)
Entity Type:Individual
Prefix:
First Name:SUKHPAL
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:ROSELYN'S CARE LLC
Other - Prefix:
Other - First Name:ROSELYN'S
Other - Middle Name:
Other - Last Name:CARE LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ROSELYN'S CARE LLC
Mailing Address - Street 1:1505 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:PORT DEPOSIT
Mailing Address - State:MD
Mailing Address - Zip Code:21904-1534
Mailing Address - Country:US
Mailing Address - Phone:443-731-1054
Mailing Address - Fax:
Practice Address - Street 1:1505 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:PORT DEPOSIT
Practice Address - State:MD
Practice Address - Zip Code:21904-1534
Practice Address - Country:US
Practice Address - Phone:443-731-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAL-00223310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility