Rolls Personal Care Home

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

437181 Issued in PA

Legal business name

ROLLS PERSONAL CARE HOME

Practice address

47 River Ave
Masontown, PA 15461-1963

Phone

(724) 952-1013

Fax

(724) 952-1020

NPI assigned

Jul 16, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Marissa Lyn Roll

Title

Owner/Operator

Phone

(724) 952-1013

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1790949030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632",
            "city": "MASONTOWN",
            "state": "PA",
            "postal_code": "154610632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 RIVER AVE",
            "city": "MASONTOWN",
            "state": "PA",
            "postal_code": "154611963",
            "telephone_number": "724-952-1013",
            "fax_number": "724-952-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLS PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "ROLL",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "724-952-1013",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "PA",
            "license": "437181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.