Provider Demographics
NPI:1417323486
Name:ROSEMARY HOME II
Entity Type:Organization
Organization Name:ROSEMARY HOME II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-291-1800
Mailing Address - Street 1:3354 GETTYSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-5208
Mailing Address - Country:US
Mailing Address - Phone:559-291-1800
Mailing Address - Fax:559-291-1880
Practice Address - Street 1:1828 SANTA ANA
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-9208
Practice Address - Country:US
Practice Address - Phone:559-291-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107200829311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home