Daylight Residential Care LLC

Primary specialty

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

Legal business name

DAYLIGHT RESIDENTIAL CARE LLC

Practice address

629 Main St
Bangor, ME 04401-6848

Phone

(682) 373-1189

NPI assigned

Apr 10, 2024

Last updated

Apr 10, 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. Francis Banoge Gisore

Title

Program Manager

Phone

(682) 373-1189

Specialties & licenses 1

Addresses

Other names 1

• Daylight Other name

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1467205294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 MAIN ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016848",
            "telephone_number": "682-373-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 MAIN ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016848",
            "telephone_number": "682-373-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYLIGHT RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "GISORE",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "BANOGE",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "682-373-1189",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "Daylight",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Travis Deabay, DPT
• Zachery Deabay, PHARMD
• Erika Dean, MS, OTR/L

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Bangor, ME
• Providers in Bangor, 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 10, 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.