Provider Demographics
NPI:1114416484
Name:ROSE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ROSE HEALTH SERVICES LLC
Other - Org Name:STONEWATER ACUPUNCTURE & CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GRADEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MSAC, LAC
Authorized Official - Phone:812-590-1584
Mailing Address - Street 1:2832 ROLLING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-8955
Mailing Address - Country:US
Mailing Address - Phone:502-694-3870
Mailing Address - Fax:
Practice Address - Street 1:152 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-5857
Practice Address - Country:US
Practice Address - Phone:812-590-1584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002964A111N00000X
IN84000197A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty