| Home Care Residential, Llc | |
|
58 Boyd St Apt 501 Portland ME 04101-7127 | |
| (202) 413-2649 | |
| Not Available |
| Full Name | Home Care Residential, Llc |
|---|---|
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 58 Boyd St Apt 501, Portland, Maine |
| Authorized Official Name and Position | Gerard Bizimana (DIRECTOR) |
| Authorized Official Contact | 2024132649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home Care Residential, Llc 58 Boyd St Apt 501 Portland ME 04101-7127 Ph: (202) 413-2649 | Home Care Residential, Llc 58 Boyd St Apt 501 Portland ME 04101-7127 Ph: (202) 413-2649 |
| NPI Number | 1669251799 |
|---|---|
| Provider Enumeration Date | 09/27/2023 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669251799 | NPI | - | NPPES |
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