Provider Demographics
NPI:1053616078
Name:ROSE CARE INCORPORATED DBA BRIGHTSTAR OF IREDELL/ROWAN
Entity type:Organization
Organization Name:ROSE CARE INCORPORATED DBA BRIGHTSTAR OF IREDELL/ROWAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:MALBASA
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-591-0138
Mailing Address - Street 1:181 N MAIN ST STE 214
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-2525
Mailing Address - Country:US
Mailing Address - Phone:704-230-2273
Mailing Address - Fax:704-660-6134
Practice Address - Street 1:181 N MAIN ST STE 214
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2525
Practice Address - Country:US
Practice Address - Phone:704-230-2273
Practice Address - Fax:704-660-6134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-22
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care