Basic Information
| Provider Information | |||||||||
| NPI: | 1265930408 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ROSECASTLE OF LECANTO, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ROSECASTLE OF CITRUS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2568 | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286032568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283225535 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 279 N LECANTO HWY | ||||||||
| Address2: | |||||||||
| City: | LECANTO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344619195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525279720 | ||||||||
| FaxNumber: | 3525278215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2018 | ||||||||
| LastUpdateDate: | 01/23/2018 | ||||||||
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| AuthorizedOfficialLastName: | AUBE | ||||||||
| AuthorizedOfficialFirstName: | CHANTAL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7274801336 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | FL | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.