Provider Demographics
NPI:1114221686
Name:ROSEMARY CHILDREN'S SERVICES
Entity Type:Organization
Organization Name:ROSEMARY CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHS
Authorized Official - Prefix:
Authorized Official - First Name:TONYI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOU-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-844-3033
Mailing Address - Street 1:36 SO. KINNELOA
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107
Mailing Address - Country:US
Mailing Address - Phone:626-844-3033
Mailing Address - Fax:626-844-3042
Practice Address - Street 1:36 S KINNELOA AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3853
Practice Address - Country:US
Practice Address - Phone:626-844-3033
Practice Address - Fax:626-844-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7374322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children