Provider Demographics
NPI:1821851940
Name:ROSE LOVING CARE HOME LLC
Entity Type:Organization
Organization Name:ROSE LOVING CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VONETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-775-6920
Mailing Address - Street 1:4332 W CENTRAL AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1669
Mailing Address - Country:US
Mailing Address - Phone:419-775-6920
Mailing Address - Fax:
Practice Address - Street 1:4332 W CENTRAL AVE STE 220
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1669
Practice Address - Country:US
Practice Address - Phone:419-775-6920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty