Provider Demographics
NPI:1558775593
Name:DESERT ROSE FL LLC
Entity Type:Organization
Organization Name:DESERT ROSE FL LLC
Other - Org Name:DESERT ROSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-587-7017
Mailing Address - Street 1:357 HIATT DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8222
Mailing Address - Country:US
Mailing Address - Phone:561-422-4946
Mailing Address - Fax:561-600-9068
Practice Address - Street 1:357 HIATT DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8222
Practice Address - Country:US
Practice Address - Phone:561-422-4946
Practice Address - Fax:561-600-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility