Fidelis Residential Care LLC

NPI #1396458790 in Gorham, Maine

Provider Information

NPI Number: 1396458790
Entity Type: Organization
Organization Name: Fidelis Residential Care LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 30, 2022
Last Updated: Dec 30, 2022

Practice Location

Address: 54 RUNNING SPRINGS RD
City: Gorham
State: Maine
ZIP Code: 04038-1633
Phone: (207) 213-9053

Authorized Official

Name: MR. BISENGIMANA GAKUNZI
Title: DIRECTOR OF FINANCE
Phone: (207) 213-9053

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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