NPI 1144935644

Fidelity Residential Care LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Portland, ME

Practice location

Address: 56 Sherman St APT 5, Portland, ME 04101-2203
Phone: (312) 402-1521

Authorised official

Name: Jean Claude Munyaneza
Title: Managing Director
Phone: (312) 402-1521

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1144935644
Entity type: Organization
NPI issued: 18 Jan 2023
Record last updated: 18 Jan 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.