Promise Residential Care LLC

Primary specialty

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

Legal business name

PROMISE RESIDENTIAL CARE LLC

Practice address

17 Charlonate Dr
Gray, ME 04039-9765

Phone

(202) 981-2408

NPI assigned

Nov 28, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Patrick Kayiranga Benerugaba

Title

Ceo

Phone

(202) 981-2408

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1732752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732752000000",
    "number": "1679399232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CHARLONATE DR",
            "city": "GRAY",
            "state": "ME",
            "postal_code": "040399765",
            "telephone_number": "202-981-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CHARLONATE DR",
            "city": "GRAY",
            "state": "ME",
            "postal_code": "040399765",
            "telephone_number": "202-981-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMISE RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-28",
        "last_updated": "2024-11-28",
        "certification_date": "2024-11-28",
        "status": "A",
        "authorized_official_last_name": "BENERUGABA",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "KAYIRANGA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-981-2408",
        "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": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Gray, ME
• Providers in Gray, 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 Nov 28, 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.