NPI 1164207239
Riverside Community Services
Practice location
- Address
- 15 Cheryl Dee Ave, Lisbon, ME 04250-6056
- Phone
- (207) 409-2638
Authorised official
- Name
- Raphael Kabata Ngaykala
- Title
- Ceo
- Phone
- (207) 409-2638
Registered specialties (2)
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Registry record
- NPI
- 1164207239
- Entity type
- Organization
- NPI issued
- 28 Aug 2023
- Record last updated
- 28 Aug 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.