Provider Demographics
NPI:1760963102
Name:LAFRENCHEE L. MCCREARY
Entity Type:Organization
Organization Name:LAFRENCHEE L. MCCREARY
Other - Org Name:ROSA'S CARING HEART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAFRENCHEE
Authorized Official - Middle Name:LILLIAN
Authorized Official - Last Name:MCCREARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-948-2054
Mailing Address - Street 1:2873 NW US 221
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32331-4531
Mailing Address - Country:US
Mailing Address - Phone:850-948-2054
Mailing Address - Fax:850-948-2054
Practice Address - Street 1:2873 NW US 221
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:FL
Practice Address - Zip Code:32331-4531
Practice Address - Country:US
Practice Address - Phone:850-948-2054
Practice Address - Fax:850-948-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
FLAL117063104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001804000Medicaid