Provider Demographics
NPI:1295825941
Name:ROSE CENTER FOR REHABILITATION, HOPE & WELLNESS INC
Entity Type:Organization
Organization Name:ROSE CENTER FOR REHABILITATION, HOPE & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:YVONNE WOOLF
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-223-9474
Mailing Address - Street 1:3278 BECHELLI LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2005
Mailing Address - Country:US
Mailing Address - Phone:530-223-9474
Mailing Address - Fax:530-223-6937
Practice Address - Street 1:3278 BECHELLI LN
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2005
Practice Address - Country:US
Practice Address - Phone:530-223-9474
Practice Address - Fax:530-223-6937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19627225100000X
CAPT12282225100000X
CAPT28548225100000X
CAPT16216225100000X
CAPT17038225100000X
CAPT39105225100000X
CAPT35731225100000X
225100000X
CAOT4528225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ32101ZMedicare PIN