Provider Demographics
NPI:1548515133
Name:ROSE CITY HOME HEALTH CARE INC
Entity type:Organization
Organization Name:ROSE CITY HOME HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-207-8914
Mailing Address - Street 1:10175 SW BARBUR BLVD SUITE 203 B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5908
Mailing Address - Country:US
Mailing Address - Phone:503-207-8914
Mailing Address - Fax:503-245-5303
Practice Address - Street 1:10175 SW BARBUR BLVD STE 203B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5908
Practice Address - Country:US
Practice Address - Phone:614-332-4598
Practice Address - Fax:614-818-4744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSE CITY HOME HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-19
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health