Provider Demographics
NPI:1548731680
Name:RED ROSE ADULT DAY HEALTH
Entity type:Organization
Organization Name:RED ROSE ADULT DAY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:LAMOTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-396-8140
Mailing Address - Street 1:3621 MORINDA DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-7275
Mailing Address - Country:US
Mailing Address - Phone:404-396-8140
Mailing Address - Fax:
Practice Address - Street 1:2148 BANKHEAD HWY STE B&C
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30116-7989
Practice Address - Country:US
Practice Address - Phone:770-834-0078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care