Provider Demographics
NPI:1710877626
Name:ROZELLE SERENITY HOMES, LLC
Entity type:Organization
Organization Name:ROZELLE SERENITY HOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONBOARDING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMELL
Authorized Official - Middle Name:
Authorized Official - Last Name:OPEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-818-1181
Mailing Address - Street 1:11807 WINDY LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-7850
Mailing Address - Country:US
Mailing Address - Phone:469-818-1181
Mailing Address - Fax:
Practice Address - Street 1:11807 WINDY LN
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-7850
Practice Address - Country:US
Practice Address - Phone:469-818-1181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility