Provider Demographics
NPI:1205218641
Name:ROSE DESERT CONGREGATE CARE INC.
Entity Type:Organization
Organization Name:ROSE DESERT CONGREGATE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:CHANNAH
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:661-206-8211
Mailing Address - Street 1:3032 W MILLING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-8390
Mailing Address - Country:US
Mailing Address - Phone:661-206-8211
Mailing Address - Fax:661-206-8211
Practice Address - Street 1:3032 W MILLING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-8390
Practice Address - Country:US
Practice Address - Phone:661-206-8211
Practice Address - Fax:661-206-8211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility