Fidelity Residential Care LLC

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

NPI 1144935644 · NPPES record last updated Jan 18, 2023

Key facts

NPI
1144935644
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
FIDELITY RESIDENTIAL CARE LLC
Practice address
56 Sherman St Apt 5
Portland, ME 04101-2203
Phone
(312) 402-1521
NPI assigned
Jan 18, 2023
Organization subpart
No

Authorized official

Name
Mr. Jean Claude Munyaneza Sr.
Title
Managing Director
Phone
(312) 402-1521

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

56 Sherman St Apt 5
Portland, ME 04101-2203

Mailing address

56 Sherman St Apt 5
Portland, ME 04101-2203
Phone (312) 402-1521

Other names

  • N/A 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.