Organization
ROSE ROAD HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ROSE (EXECUTIVE DIRECTOR)
(801) 680-7805
Entity
Organization
Contact information
Practice address
5677 S 1475 E STE 4A, SOUTH OGDEN, UT 84403-7003
(385) 222-3737
(385) 222-3738
Mailing address
5677 S 1475 E STE 4A, SOUTH OGDEN, UT 84403-7003
(385) 222-3737
(385) 222-3738
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10068
UT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/07/2015
Last updated
02/04/2022
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