Provider Demographics
NPI:1629562491
Name:ROSE'S TERRACE INC
Entity Type:Organization
Organization Name:ROSE'S TERRACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINACIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHITRA
Authorized Official - Middle Name:PAMELA
Authorized Official - Last Name:SAWH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-334-2621
Mailing Address - Street 1:1924 NEPTUNE RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4939
Mailing Address - Country:US
Mailing Address - Phone:407-334-2621
Mailing Address - Fax:
Practice Address - Street 1:1924 NEPTUNE RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4939
Practice Address - Country:US
Practice Address - Phone:407-334-2621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility