Rosewell Home and Residential Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12708 Issued in FL

Legal business name

ROSEWELL HOME AND RESIDENTIAL CARE, LLC

Practice address

3366 SW Vendome St
Port Saint Lucie, FL 34953-3407

Phone

(772) 777-4463

Fax

(772) 673-6203

NPI assigned

Oct 6, 2015

Last updated

Oct 6, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Icylin Douglas

Title

Administrator

Phone

(772) 777-4463

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1760852552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 SW VENDOME ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533407",
            "telephone_number": "772-777-4463",
            "fax_number": "772-673-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 SW VENDOME ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533407",
            "telephone_number": "772-777-4463",
            "fax_number": "772-673-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEWELL HOME AND RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "ICYLIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-777-4463",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Abigail Rosen, PTA
• Jenny Rosete
• Gerald Alan Ross, D.O.
• Taryn Elizabeth Ross, APRN, FNP-BC
• Edward Jesus Rossario Jr., MD
• Melissa Rowell, MS
• Royal Palm Beach Rehab Corp (Action Physical Therapy)

• Assisted Living Facility in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.