Provider Demographics
NPI:1013632124
Name:ROLLING MEADOWS CARE HOMES INC.
Entity type:Organization
Organization Name:ROLLING MEADOWS CARE HOMES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RETZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-548-0138
Mailing Address - Street 1:14450 VICTORIA ESTATES LANE
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064
Mailing Address - Country:US
Mailing Address - Phone:520-548-0138
Mailing Address - Fax:
Practice Address - Street 1:14450 VICTORIA ESTATES LANE
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064
Practice Address - Country:US
Practice Address - Phone:520-548-0138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility