Provider Demographics
NPI:1427564335
Name:ROSEWOOD RANCH, LP
Entity Type:Organization
Organization Name:ROSEWOOD RANCH, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, MBA
Authorized Official - Phone:470-440-1647
Mailing Address - Street 1:2300 WINDY RIDGE PKWY SE STE 210
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5665
Mailing Address - Country:US
Mailing Address - Phone:470-440-1647
Mailing Address - Fax:
Practice Address - Street 1:36075 S RINCON RD
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-2491
Practice Address - Country:US
Practice Address - Phone:928-684-9594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERMEND HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-1594283Q00000X, 323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility