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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.