Provider Demographics
NPI:1255703179
Name:ROSE AND MARY ALF LLC
Entity type:Organization
Organization Name:ROSE AND MARY ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-317-9550
Mailing Address - Street 1:7430 OAKVISTA CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7430 OAKVISTA CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2939
Practice Address - Country:US
Practice Address - Phone:813-317-9550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSE AND MARY ALF LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12745310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility