Provider Demographics
NPI:1588254114
Name:ROSE ROCK HOME HEALTH LLC
Entity type:Organization
Organization Name:ROSE ROCK HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-631-6437
Mailing Address - Street 1:2232 DELL RANGE BLVD STE 309
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4902
Mailing Address - Country:US
Mailing Address - Phone:307-277-2459
Mailing Address - Fax:
Practice Address - Street 1:2232 DELL RANGE BLVD STE 309
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4902
Practice Address - Country:US
Practice Address - Phone:307-277-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health