Provider Demographics
NPI:1134259955
Name:ROSEMONT PERSONAL CARE HOME, INC.
Entity type:Organization
Organization Name:ROSEMONT PERSONAL CARE HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERLITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VELASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:713-468-7673
Mailing Address - Street 1:10927 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043
Mailing Address - Country:US
Mailing Address - Phone:713-468-7673
Mailing Address - Fax:713-468-7374
Practice Address - Street 1:10927 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043
Practice Address - Country:US
Practice Address - Phone:713-468-7673
Practice Address - Fax:713-468-7374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119221310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149558Medicaid