Organization
ROUSSEAU ENTERPRISES, INC.
Active
Other names
Amenity Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL A. ROUSSEAU (PRESIDENT)
(207) 725-4071
Entity
Organization
Contact information
Practice address
29 ELM ST, TOPSHAM, ME 04086-1423
(207) 725-7495
(207) 725-7195
Mailing address
29 ELM ST, TOPSHAM, ME 04086-1423
(207) 725-7495
(207) 725-7195
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
35865
ME
314000000X
Skilled Nursing Facility
35865
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111890001
—
ME
Enumeration date
09/07/2005
Last updated
03/09/2011
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