Excellent Residential Care LLC

Primary specialty

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

Legal business name

EXCELLENT RESIDENTIAL CARE LLC

Practice address

60 Woodland Rd Apt B5
Cape Elizabeth, ME 04107-1259

Phone

(704) 777-2188

NPI assigned

Dec 12, 2020

Last updated

Dec 12, 2020By 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. Morris Butsitsi, DSP

Title

Operations Manager

Phone

(704) 777-2188

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1607731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607731200000",
    "number": "1861088064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WOODLAND RD APT B5",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041071259",
            "telephone_number": "704-777-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WOODLAND RD APT B5",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041071259",
            "telephone_number": "704-777-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-12",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A",
        "authorized_official_last_name": "BUTSITSI",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "704-777-2188",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DSP"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Dicianni, PT
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• Julie Ewald, M.A./O.T.R.L.
• Marita Fichera, FNP-BC
• Jennifer-Lynn Flynn, NP
• Stephanie Fortier
• Betty L Fortuin, LCSW
• Jennifer Lynn Freligh

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Cape Elizabeth, ME
• Providers in Cape Elizabeth, 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 Dec 12, 2020; 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.