Organization · NPI-2

Act Residential Care

In Home Supportive Care · Portland, ME

NPI number1265939748
StatusActive
Last updated in NPPESAug 28, 2023

Details

NPI
1265939748
Entity type
Organization (NPI-2)
Legal business name
Act Residential Care
Organization subpart
No
Enumeration date
Apr 10, 2018
Certification date
Aug 28, 2023
Last updated
Aug 28, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253Z00000X In Home Supportive Care––Yes

Practice location

63 Frederic St Apt 202
Portland, ME 04102-2762

Phone 207-409-2638

Mailing address

63 Frederic St Apt 202
Portland, ME 04102-2762

Phone 207-409-2638

Authorized official

Raphael Kabata Ngaykala
Executive Director
2014092638

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