- Enrollment id
- O20141008002239
- Enrollment state
- TX
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1073927018
- Multiple npi flag
- N
- Ccn
- 675603
- Associate id
- 3870712482
- Organization name
- WINNIE-STOWELL HOSPITAL DISTRICT
- Doing business as name
- ROSE HAVEN RETREAT
- Organization type structure
- OTHER
- Organization other type text
- HOSPITAL DISTRICT
- Proprietary nonprofit
- N
- Nursing home provider name
- ROSE HAVEN RETREAT
- Affiliation entity name
- CARING HEALTHCARE GROUP
- Affiliation entity id
- 113
- Address line 1
- 200 LIVE OAK ST
- City
- ATLANTA
- State
- TX
- Zip code
- 755512802