Dirigo Residential Care LLC

Primary specialty

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

Legal business name

DIRIGO RESIDENTIAL CARE LLC

Practice address

1500 Forest Ave Apt 7D
Portland, ME 04103-1840

Phone

(207) 409-2798

NPI assigned

Apr 1, 2025

Last updated

Apr 1, 2025By 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

Dominique Mazambo

Title

Ceo

Phone

(207) 409-2798

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743465600000",
    "number": "1285438283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 FOREST AVE APT 7D",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031840",
            "telephone_number": "207-409-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FOREST AVE APT 7D",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031840",
            "telephone_number": "207-409-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRIGO RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "MAZAMBO",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-409-2798"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul E Dionne Jr., CRNA
• Rachel A Dionne, AGACNP
• Gary Diperna, DO
• Laura Taylor Director, MD
• Dirigo Physical Therapy and Performance
• Arthur J Dirocco, PH.D.
• Jennifer Dirusso, M.S., CCC-SLP
• Alison Jean Mehlhorn Disciullo, MD
• Distinct Solutions Therapy LLC
• Heather Marie Diyenno, LCSW

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portland, ME
• Providers in 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 Apr 1, 2025; 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.