Provider Demographics
NPI:1639298169
Name:ROSELAND HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:ROSELAND HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:NNENNE
Authorized Official - Last Name:AMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-301-1960
Mailing Address - Street 1:9555 W SAM HOUSTON PKWY S STE 325
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-2145
Mailing Address - Country:US
Mailing Address - Phone:713-301-1960
Mailing Address - Fax:713-270-6207
Practice Address - Street 1:9555 W SAM HOUSTON PKWY S STE 325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-2145
Practice Address - Country:US
Practice Address - Phone:713-270-6200
Practice Address - Fax:713-270-6207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009668251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014631Medicaid