# ROUBAL'S NURSING HOME, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Roubal Care and Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457346801
- **Authorized official:** BENJAMIN T FRIEDMAN (SHAREHOLDER)
- **Authorized official phone:** (847) 881-6025

## Contact information

- **Practice address:** N306 MAPLE ST, STEPHENSON, MI 49887-8910
- **Practice address phone:** (906) 753-4981
- **Practice address fax:** (906) 753-4680
- **Mailing address:** N306 MAPLE ST, STEPHENSON, MI 49887-8910
- **Mailing address phone:** (906) 753-4981
- **Mailing address fax:** (906) 753-4680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 554020 | MI | Yes |

## Other

- **Enumeration date:** 09/13/2005
- **Last updated:** 05/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1508658 | — | MI |