Provider Demographics
NPI:1154176337
Name:ROSE HEART HOME CARE LLC
Entity type:Organization
Organization Name:ROSE HEART HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BECKTON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:850-866-2731
Mailing Address - Street 1:115 CHRISTIE LN
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-7666
Mailing Address - Country:US
Mailing Address - Phone:850-866-2731
Mailing Address - Fax:850-640-0250
Practice Address - Street 1:115 CHRISTIE LN
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-7666
Practice Address - Country:US
Practice Address - Phone:850-866-2731
Practice Address - Fax:850-640-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care