Agape Residential Care LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Portland, ME

NPI 1124893391 · NPPES record last updated Nov 17, 2023

Key facts

NPI
1124893391
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
AGAPE RESIDENTIAL CARE LLC
Practice address
124 Wellesley Ests
Portland, ME 04103-1185
Phone
(207) 409-4723
NPI assigned
Nov 17, 2023
Organization subpart
No

Authorized official

Name
Mr. Edison Ntiyomba Sr.
Title
Ceo
Phone
(207) 409-4723

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

124 Wellesley Ests
Portland, ME 04103-1185

Mailing address

124 Wellesley Ests
Portland, ME 04103-1185
Phone (207) 409-4723

Other names

  • Agape Residential Care LLC Doing business as

Other providers in Portland, ME

All providers in Portland, ME · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

Sources for this page

Verify at the official NPI Registry.