Provider Demographics
NPI:1114509916
Name:BLOOMING ROSE HOME CARE LLC
Entity Type:Organization
Organization Name:BLOOMING ROSE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-759-4378
Mailing Address - Street 1:7901 STONERIDGE DR STE 109
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3677
Mailing Address - Country:US
Mailing Address - Phone:510-988-8894
Mailing Address - Fax:
Practice Address - Street 1:7901 STONERIDGE DR STE 109
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3677
Practice Address - Country:US
Practice Address - Phone:510-988-8894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care