Home Care Residential, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

HOME CARE RESIDENTIAL, LLC

Practice address

58 Boyd St Apt 501
Portland, ME 04101-7127

Phone

(202) 413-2649

NPI assigned

Sep 27, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gerard Bizimana

Title

Director

Phone

(202) 413-2649

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1669251799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 BOYD ST APT 501",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041017127",
            "telephone_number": "202-413-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 BOYD ST APT 501",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041017127",
            "telephone_number": "202-413-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME CARE RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "BIZIMANA",
        "authorized_official_first_name": "GERARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "202-413-2649"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Richard Holt I
• William S Holt, M.D.
• Saffron Homayoun Mirza, MD
• Home Care Connect LLC
• Home Care Plus LLC
• Home for the Aged
• Home Health Care Solutions
• Home Nursing Care LLC
• Homehaven LLC
• Harrison Noah Homer, MD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Portland, ME
• Providers in Portland, ME by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.