Provider Demographics
NPI:1417116120
Name:LIN ROS BES T HOME CARE
Entity Type:Organization
Organization Name:LIN ROS BES T HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QMRP/LICENSEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSENDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS CHEMISTRY
Authorized Official - Phone:562-867-0792
Mailing Address - Street 1:6127 FAUST AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-1109
Mailing Address - Country:US
Mailing Address - Phone:310-518-5178
Mailing Address - Fax:310-518-5005
Practice Address - Street 1:254 E 228TH ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-4813
Practice Address - Country:US
Practice Address - Phone:310-518-5178
Practice Address - Fax:310-518-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities