Provider Demographics
NPI:1639269129
Name:ROSE MOUNTAIN CARE CENTER, INC.
Entity Type:Organization
Organization Name:ROSE MOUNTAIN CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-828-2400
Mailing Address - Street 1:ROUTE 1 AND 18
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1551
Mailing Address - Country:US
Mailing Address - Phone:732-828-2400
Mailing Address - Fax:732-828-2494
Practice Address - Street 1:ROUTE 1 AND 18
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1551
Practice Address - Country:US
Practice Address - Phone:732-828-2400
Practice Address - Fax:732-828-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061204314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4485301Medicaid
NJ315384Medicare ID - Type Unspecified