Organization
IMPACTFUL RESIDENTIAL CARE, LLC
Active
Other names
IRC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASSUMPTA MUKABUTERA MPH, PH.D (CEO)
(207) 310-3101
Entity
Organization
Contact information
Practice address
27 SEAVEY ST, WESTBROOK, ME 04092-4336
(571) 278-6103
Mailing address
PO BOX 8057, PORTLAND, ME 04104-8057
(207) 310-3101
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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