Provider Demographics
NPI:1548641855
Name:SHARON'S ROSES LLC
Entity type:Organization
Organization Name:SHARON'S ROSES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LYNNETTE
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS
Authorized Official - Phone:980-729-2179
Mailing Address - Street 1:10106 PINTAIL PL APT 205
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1927
Mailing Address - Country:US
Mailing Address - Phone:980-729-2179
Mailing Address - Fax:
Practice Address - Street 1:10106 PINTAIL PL APT 205
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1927
Practice Address - Country:US
Practice Address - Phone:980-729-2179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health