Provider Demographics
NPI:1780963025
Name:ROSEMARIES MY HOME AWAY FROM HOME CORP
Entity type:Organization
Organization Name:ROSEMARIES MY HOME AWAY FROM HOME CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-655-0872
Mailing Address - Street 1:1936 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-3744
Mailing Address - Country:US
Mailing Address - Phone:904-655-0872
Mailing Address - Fax:
Practice Address - Street 1:262 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-4010
Practice Address - Country:US
Practice Address - Phone:904-655-0872
Practice Address - Fax:904-677-7945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility