Provider Demographics
NPI:1134471089
Name:ROSEWOOD COURT
Entity Type:Organization
Organization Name:ROSEWOOD COURT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:T
Authorized Official - Last Name:EISENBEIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-883-5363
Mailing Address - Street 1:320 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:LAMOURE
Mailing Address - State:ND
Mailing Address - Zip Code:58458-7164
Mailing Address - Country:US
Mailing Address - Phone:701-883-5999
Mailing Address - Fax:701-883-5711
Practice Address - Street 1:315 1ST ST SE
Practice Address - Street 2:
Practice Address - City:LAMOURE
Practice Address - State:ND
Practice Address - Zip Code:58458-7132
Practice Address - Country:US
Practice Address - Phone:701-883-5363
Practice Address - Fax:701-883-5711
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. ROSE CARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND43310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility