Provider Demographics
NPI:1164095527
Name:GENTLE ROSE HOME CARE LLC
Entity Type:Organization
Organization Name:GENTLE ROSE HOME CARE LLC
Other - Org Name:GENTLE ROSE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-914-5778
Mailing Address - Street 1:6550 VALLEY HILL DR SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5152
Mailing Address - Country:US
Mailing Address - Phone:317-914-5778
Mailing Address - Fax:
Practice Address - Street 1:6550 VALLEY HILL DR SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5152
Practice Address - Country:US
Practice Address - Phone:317-914-5778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health