Organization
ESSENTIAL ROSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHAYLA MARIE DE LA ROSE SLP-A, MBA (PRESIDENT/CEO)
(504) 220-8480
Entity
Organization
Contact information
Practice address
701 LOYOLA AVE, UNIT 57464, NEW ORLEANS, LA 70157-5001
(504) 220-8480
Mailing address
701 LOYOLA AVENUE, UNIT 57464, NEW ORLEANS, LA 70157
(504) 220-8480
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
4860
LA
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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