Organization
BRIGHT STAR RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC SURU (CEO)
(207) 409-4577
Entity
Organization
Contact information
Practice address
75 BISHOP ST STE 12, PORTLAND, ME 04103-2614
(207) 409-4577
Mailing address
75 BISHOP ST STE 12, PORTLAND, ME 04103-2614
(207) 409-4577
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
10/27/2024
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