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ROSE TARA PLANTATION, INC
NPI 1902822182
Custodial Care Facility - Adult Care Home in King, NC

Active since July 14, 2006CLIA 34D2019494 · Waiver
125 PLANTATION DR, KING, NC 27021(336) 983-8929(336) 983-7424 Get Directions Write a Review

NPPES record last updated: October 11, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 11, 2021, Aug 22, 2020 (2 updates tracked since 2020).

About Rose Tara Plantation, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROSE TARA PLANTATION, INC (NPI 1902822182) is a healthcare organization registered as an adult care home in King, North Carolina and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists Charles E Trefzger, Manager, as its authorized official.

NPPES Registry Identity

NPI1902822182
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameROSE TARA HOLDINGS, LLC
Location Address125 PLANTATION DRKing, NC 27021-9590
Mailing AddressPo Box 2568Hickory, NC 28603-2568 · (828) 322-5535 · Fax (828) 322-9587
Phone(336) 983-8929
Fax(336) 983-7424
Organization SubpartNo
Authorized OfficialCharles E TrefzgerManager · (828) 322-5535
Enumeration DateJuly 14, 2006
Last NPPES UpdateOctober 11, 20212 updates tracked since enumeration
NPPES CertifiedOctober 11, 2021
✔ NPI 1902822182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Also ListedAssisted Living FacilityTaxonomy 310400000X · License HAL-085-008 (NC)
Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X
125 PLANTATION DR, King, NC 27021
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Other Names 2

Doing Business AsRose Tara Plantation, Inc
Doing Business AsRose Tara Senior Living

Other Identifiers 1

Medicaid7805465NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2019494

Rose Tara Plantation · King, NC
Active · expires Jan 30, 2027
CLIA Number34D2019494
Laboratory TypeAssisted Living Facility
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorBrenda Y. Peddycord
Laboratory Phone(336) 983-8929
Laboratory LocationRose Tara Plantation125 Plantatioin Drive, King, NC 27021
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rose Tara Holdings, LLC's NPI number?

The NPI number for Rose Tara Holdings, LLC is 1902822182. It was assigned to this organization in the NPPES registry on July 14, 2006. The provider is doing business as Rose Tara Plantation, Inc and Rose Tara Senior Living.

Where is Rose Tara Holdings, LLC located?

Rose Tara Holdings, LLC is located at 125 Plantation Dr, King, NC 27021. The listed phone number is (336) 983-8929.

What is Rose Tara Holdings, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Rose Tara Holdings, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2019494) is associated with this NPI, valid through January 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Rose Tara Holdings, LLC was last updated on October 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.