Provider Demographics
NPI:1447574298
Name:ROSEWOOD HEALTH AND REHAB CENTER, LLC
Entity Type:Organization
Organization Name:ROSEWOOD HEALTH AND REHAB CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-982-2300
Mailing Address - Street 1:7434 SKOKIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3341
Mailing Address - Country:US
Mailing Address - Phone:847-982-2300
Mailing Address - Fax:847-982-2304
Practice Address - Street 1:1415 W WHITE OAK ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-2590
Practice Address - Country:US
Practice Address - Phone:816-254-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO030869314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO265786Medicare Oscar/Certification