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Organization

PATHWAY RESIDENTIAL SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE MUGISHA (MANAGING MEMBER)
(405) 861-4998
Entity
Organization

Contact information

Practice address
27 DUCHAINE DR, GORHAM, ME 04038-2085
(405) 861-4998
Mailing address
27 DUCHAINE DR, GORHAM, ME 04038-2085
(405) 961-4998

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
04/02/2026
Last updated
04/02/2026
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