Organization
GENESIS SUPPORT SOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY KIBAMBA (MANAGING MEMBER)
(804) 665-8185
Entity
Organization
Contact information
Practice address
6 HARPERS WAY, WINDHAM, ME 04062-6940
(804) 665-8185
Mailing address
6 HARPERS WAY, WINDHAM, ME 04062-6940
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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