Whalio Doctors

NPI 1306480108

Pine Peak Care LLC

Organisation Mental Illness Community Based Residential Treatment Facility Portland, ME

Practice location

Address
13 Sara Ln, Portland, ME 04103-3622
Phone
(207) 415-6894

Authorised official

Name
Manasse Shingiro
Title
Managing Member
Phone
(207) 415-6894

Registered specialties (2)

Mental Illness Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320800000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320900000X

Registry record

NPI
1306480108
Entity type
Organization
NPI issued
5 Nov 2019
Record last updated
5 Nov 2019

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.