Organization
ROSEKITCHEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEAN DESTRADE (OWNER)
(845) 304-0322
Entity
Organization
Contact information
Practice address
8 HIGH MOUNTAIN RD, POMONA, NY 10970-2124
(845) 304-0322
Mailing address
8 HIGH MOUNTAIN RD, POMONA, NY 10970-2124
(845) 304-0322
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
341600000X
Ambulance
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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