Provider Demographics
NPI:1285278820
Name:ROSE HOLISTIC HOMECARE.LLC
Entity type:Organization
Organization Name:ROSE HOLISTIC HOMECARE.LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/NURSE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIKISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:757-951-3590
Mailing Address - Street 1:4410 CLAIBORNE SQ E STE 334
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2074
Mailing Address - Country:US
Mailing Address - Phone:757-951-3590
Mailing Address - Fax:
Practice Address - Street 1:739 THIMBLE SHOALS BLVD STE 504
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3562
Practice Address - Country:US
Practice Address - Phone:757-951-3590
Practice Address - Fax:757-586-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty