Provider Demographics
NPI:1942239595
Name:D. C. HOLDINGS, INC.
Entity Type:Organization
Organization Name:D. C. HOLDINGS, INC.
Other - Org Name:DIONNE COMMONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROUSSEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-725-4071
Mailing Address - Street 1:11 BANK ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1501
Mailing Address - Country:US
Mailing Address - Phone:207-725-4071
Mailing Address - Fax:207-725-4424
Practice Address - Street 1:24 MAURICE DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3270
Practice Address - Country:US
Practice Address - Phone:207-725-4379
Practice Address - Fax:207-725-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS2171310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432116400Medicaid