Organization
LISUNGI GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BOBE RN (CHIEF EXECUTIVE OFFICER (CEO))
(207) 409-8837
Entity
Organization
Contact information
Practice address
18 EVERETT ST, WESTBROOK, ME 04092-3013
(207) 409-8837
Mailing address
18 EVERETT ST, WESTBROOK, ME 04092-3013
(207) 409-8837
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/01/2023
Last updated
12/08/2023
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