Provider Demographics
NPI:1194382291
Name:WHITE ROSE PLUS, LLC
Entity type:Organization
Organization Name:WHITE ROSE PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEPIDEH
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEKHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-752-0706
Mailing Address - Street 1:330 S MICHIGAN AVE APT 1709
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-4336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 S 32ND AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-3958
Practice Address - Country:US
Practice Address - Phone:312-291-1342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care