Provider Demographics
NPI:1669903647
Name:LILLETTE ROSETE
Entity type:Organization
Organization Name:LILLETTE ROSETE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LILETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-247-0815
Mailing Address - Street 1:960 VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126
Mailing Address - Country:US
Mailing Address - Phone:408-247-0815
Mailing Address - Fax:408-247-0924
Practice Address - Street 1:960 VERMONT ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126
Practice Address - Country:US
Practice Address - Phone:408-247-0815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSE GARDEN COURT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435200967310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility