Fidelis Residential Care LLC

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

NPI 1396458790 · NPPES record last updated Dec 30, 2022

Key facts

NPI
1396458790
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
FIDELIS RESIDENTIAL CARE LLC
Practice address
54 Running Springs Rd
Gorham, ME 04038-1633
Phone
(207) 213-9053
NPI assigned
Dec 30, 2022
Organization subpart
No

Authorized official

Name
Mr. Bisengimana Gakunzi
Title
Director of Finance
Phone
(207) 213-9053

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

54 Running Springs Rd
Gorham, ME 04038-1633

Mailing address

54 Running Springs Rd
Gorham, ME 04038-1633

Other providers in Gorham, ME

All providers in Gorham, ME · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

Sources for this page

Verify at the official NPI Registry.