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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Other providers in Portland, ME
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- Kiara Paige Field
- Susan J Fielding
- Samantha Marie Fields
- Alexandra McColl Marcotte Fierros
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All providers in Portland, ME · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.