Camilia Rose Company Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

326976 Issued in MN

Legal business name

CAMILIA ROSE COMPANY INC

Practice address

11800 Xeon Blvd NW
Coon Rapids, MN 55448-2061

Phone

(763) 755-8400

Fax

(783) 755-8578

NPI assigned

Sep 29, 2005

Organization subpart

Yes

Parent organization

CAMILIA ROSE COMPANY INCAs reported in NPPES

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

Authorized official

Name

Jason Tjosvold

Title

Secretary & Treasurer

Phone

(763) 567-8951

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CAMILIA ROSE CARE CENTER LLC Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Camilia Rose Company Inc

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1962499566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 XEON BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554482061",
            "telephone_number": "763-755-8400",
            "fax_number": "783-755-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 XEON BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554482061",
            "telephone_number": "763-755-8400",
            "fax_number": "783-755-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMILIA ROSE COMPANY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMILIA ROSE COMPANY INC",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "TJOSVOLD",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "SECRETARY & TREASURER",
        "authorized_official_telephone_number": "763-567-8951"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "326976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231243300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMILIA ROSE CARE CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAMILIA ROSE CARE CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Daniel Byers, M.D.
• Cassandra M Calendine, LAC
• Dennis John Callahan, MD
• Catherine M Callaway, CRNA
• James Adair Cameron, M.D.
• Camilia Rose Group Home
• Leah R Campbell
• Kelsey Canfield, MS, OTR/L
• Romero Cannady
• Keith A Canter, D.P.M.

• Skilled Nursing Facility in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.