Provider Demographics
NPI:1124392196
Name:ROSE VIEW LLC
Entity Type:Organization
Organization Name:ROSE VIEW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAFFIN
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:419-526-0124
Mailing Address - Fax:419-522-4391
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:419-526-0124
Practice Address - Fax:419-522-4391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities