Provider Demographics
NPI:1700478823
Name:VINTAGE ROSE LLC
Entity Type:Organization
Organization Name:VINTAGE ROSE LLC
Other - Org Name:COMPASSIONATE HELPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPN / CEO
Authorized Official - Prefix:
Authorized Official - First Name:MYLECE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-530-5967
Mailing Address - Street 1:19815 MOUNTAIN VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7182
Mailing Address - Country:US
Mailing Address - Phone:214-530-5967
Mailing Address - Fax:
Practice Address - Street 1:24285 KATY FWY STE 300
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1327
Practice Address - Country:US
Practice Address - Phone:214-530-5967
Practice Address - Fax:888-687-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy