Provider Demographics
NPI:1235891003
Name:ROSE GARDEN HEALTH SERVICES
Entity Type:Organization
Organization Name:ROSE GARDEN HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONSONYA
Authorized Official - Middle Name:CUPRICE
Authorized Official - Last Name:PATMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-538-8087
Mailing Address - Street 1:5378 SILVER WOODS WALK
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-9073
Mailing Address - Country:US
Mailing Address - Phone:678-549-2323
Mailing Address - Fax:
Practice Address - Street 1:404 NORTHSTAR DR
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-5560
Practice Address - Country:US
Practice Address - Phone:678-538-8087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSE GARDEN HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-09
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care