Provider Demographics
NPI:1124706056
Name:ROSEBROOKE SENIOR LIVING INC
Entity type:Organization
Organization Name:ROSEBROOKE SENIOR LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:715-207-1419
Mailing Address - Street 1:550 W LIBERTY STREET
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:WI
Mailing Address - Zip Code:53910
Mailing Address - Country:US
Mailing Address - Phone:608-339-9444
Mailing Address - Fax:608-399-3824
Practice Address - Street 1:550 W LIBERTY STREET
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:WI
Practice Address - Zip Code:53910
Practice Address - Country:US
Practice Address - Phone:608-339-9444
Practice Address - Fax:608-399-3824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility