Provider Demographics
NPI:1689044307
Name:ST JOSEPH'S MEMORY CARE, INC.
Entity Type:Organization
Organization Name:ST JOSEPH'S MEMORY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-728-6324
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:FRENCHVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04745-0469
Mailing Address - Country:US
Mailing Address - Phone:207-543-6648
Mailing Address - Fax:
Practice Address - Street 1:426 U.S. ROUTE 1
Practice Address - Street 2:
Practice Address - City:FRENCHVILLE
Practice Address - State:ME
Practice Address - Zip Code:04745-0469
Practice Address - Country:US
Practice Address - Phone:207-543-6648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)