Dignity Residential Care LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

DIGNITY RESIDENTIAL CARE LLC

Doing business as

Dignity Residential Care LLC

Practice address

712 Westbrook St Apt 4
South Portland, ME 04106-1993

Phone

(617) 347-0448

NPI assigned

Jan 3, 2024

Last updated

Jan 3, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Providence Mbabazi Sr.

Title

Ceo

Phone

(617) 347-0448

Specialties & licenses 1

Addresses

Other names 1

• Dignity Residential Care LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1255101135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 WESTBROOK ST APT 4",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061993",
            "telephone_number": "617-347-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 WESTBROOK ST APT 4",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061993",
            "telephone_number": "617-347-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "MBABAZI",
        "authorized_official_first_name": "PROVIDENCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-347-0448",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dignity Residential Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Ann Diaz-Hyde, LCSW
• Judith Lynn Dickson, AGACNP
• Daniel J Diekema, MD
• Dignity Life LLC
• Dignity Life LLC
• Trudy Dill
• Anya Dissen, RDN, LD
• Divine Core LLC
• Divine Residential Care LLC
• Elizabeth A Doane, L.AC.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in South Portland, ME
• Providers in South Portland, ME by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.