Organization
ROSE OF SHARON GARDEN ALF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLINE ROBERTS JACKSON CNA, MA. (ADMINISTRATOR)
(954) 821-7511
Entity
Organization
Contact information
Practice address
8400 NW 28 ST., SUNRISE, FL 33322
(954) 747-0869
(954) 749-9644
Mailing address
8400 NW 28TH ST, SUNRISE, FL 33322-2314
(954) 747-0869
(954) 749-9644
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AL10291
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002673200
—
FL
Enumeration date
04/09/2012
Last updated
04/09/2012
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