Provider Demographics
NPI:1366214389
Name:ROSEMONTE ASSISTED LIVING II LLC
Entity type:Organization
Organization Name:ROSEMONTE ASSISTED LIVING II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:MOGAKA
Authorized Official - Last Name:MOKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-242-1619
Mailing Address - Street 1:902 E ROSEMONTE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-2932
Mailing Address - Country:US
Mailing Address - Phone:480-242-1619
Mailing Address - Fax:
Practice Address - Street 1:902 E ROSEMONTE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-2932
Practice Address - Country:US
Practice Address - Phone:480-242-1619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility