Provider Demographics
NPI:1952034415
Name:ROSEWOOD MASTER TENANT LLC
Entity Type:Organization
Organization Name:ROSEWOOD MASTER TENANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-789-5345
Mailing Address - Street 1:2550 SE CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-8319
Mailing Address - Country:US
Mailing Address - Phone:503-259-8999
Mailing Address - Fax:
Practice Address - Street 1:2550 SE CENTURY BLVD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-8319
Practice Address - Country:US
Practice Address - Phone:503-259-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)