Provider Demographics
NPI:1144523697
Name:ROPERS PERSONAL HOME CARE
Entity type:Organization
Organization Name:ROPERS PERSONAL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ALF
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-643-8607
Mailing Address - Street 1:PO BOX 735
Mailing Address - Street 2:
Mailing Address - City:BLOUNTSTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:32424-0735
Mailing Address - Country:US
Mailing Address - Phone:850-643-8607
Mailing Address - Fax:850-674-5144
Practice Address - Street 1:17112 NW CHARLIE JOHNS ST
Practice Address - Street 2:
Practice Address - City:BLOUNTSTOWN
Practice Address - State:FL
Practice Address - Zip Code:32424-1308
Practice Address - Country:US
Practice Address - Phone:850-643-8607
Practice Address - Fax:850-674-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL-123104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL140805400Medicaid