Outfront JB Family Residential Care LLC

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

NPI 1578069415 · NPPES record last updated Mar 31, 2018

Key facts

NPI
1578069415
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
OUTFRONT JB FAMILY RESIDENTIAL CARE LLC
Practice address
41 Front St
Portland, ME 04103-4951
Phone
(848) 214-0024
NPI assigned
Mar 31, 2018
Organization subpart
No

Authorized official

Name
Johnboosco Oboma
Title
Owner
Phone
(848) 214-0024

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

41 Front St
Portland, ME 04103-4951

Mailing address

41 Front St
Portland, ME 04103-4951
Phone (848) 214-0024

Other providers in Portland, ME

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

Sources for this page

Verify at the official NPI Registry.