Organization
DIVERSICARE ROSE TERRACE, LLC
Active
Parent organization
ADVOCAT INC.
Other names
Rose Terrace Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVOCAT INC.
Authorized official
KELLY J. GILL (PRESIDENT AND CEO)
(615) 771-7575
Entity
Organization
Contact information
Practice address
30 HIDDEN BROOK WAY, CULLODEN, WV 25510
(615) 771-7575
(615) 620-7875
Mailing address
30 HIDDEN BROOK WAY, CULLODEN, WV 25510
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
183
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810023465
—
WV
01
—
51-5192
MEDICARE SNF
WV
Enumeration date
04/29/2011
Last updated
11/14/2012
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