Act Residential Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ACT RESIDENTIAL CARE

Practice address

63 Frederic St Apt 202
Portland, ME 04102-2762

Phone

(207) 409-2638

NPI assigned

Apr 10, 2018

Organization subpart

No

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

Authorized official

Name

Raphael Kabata Ngaykala

Title

Executive Director

Phone

(201) 409-2638

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1265939748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 FREDERIC ST APT 202",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022762",
            "telephone_number": "207-409-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 FREDERIC ST APT 202",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022762",
            "telephone_number": "207-409-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACT RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "KABATA NGAYKALA",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "201-409-2638"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.