Destiny Residential Care, Llc | |
15 Teri Cir Apt 82 Westbrook ME 04092-3972 | |
(207) 317-7828 | |
Not Available |
Full Name | Destiny Residential Care, Llc |
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Speciality | Community/behavioral Health |
Location | 15 Teri Cir Apt 82, Westbrook, Maine |
Authorized Official Name and Position | Anicet Bakunda (MANAGING MEMBER) |
Authorized Official Contact | 2073177828 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Destiny Residential Care, Llc 15 Teri Cir Apt 82 Westbrook ME 04092-3972 Ph: (207) 317-7828 | Destiny Residential Care, Llc 15 Teri Cir Apt 82 Westbrook ME 04092-3972 Ph: (207) 317-7828 |
NPI Number | 1104596493 |
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Provider Enumeration Date | 09/17/2021 |
Last Update Date | 09/17/2021 |
Certification Date | 08/27/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104596493 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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