Provider Demographics
NPI:1891142006
Name:ROSE GARDEN SUBACUTE & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:ROSE GARDEN SUBACUTE & REHABILITATION CENTER LLC
Other - Org Name:ROSE GARDEN HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOV
Authorized Official - Middle Name:E
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-398-8101
Mailing Address - Street 1:1899 N RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-1733
Mailing Address - Country:US
Mailing Address - Phone:626-797-2120
Mailing Address - Fax:626-797-2536
Practice Address - Street 1:1899 N RAYMOND AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1733
Practice Address - Country:US
Practice Address - Phone:626-797-2120
Practice Address - Fax:626-797-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility