Organization
MOTHER MARY HOME CARE LLC
Active
Other names
Mother Mary Home Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR IRYAYO SR. (CEO)
(612) 205-1753
Entity
Organization
Contact information
Practice address
444 SAWYER ST APT 5, SOUTH PORTLAND, ME 04106-3944
(612) 205-1753
Mailing address
444 SAWYER ST APT 5, SOUTH PORTLAND, ME 04106-3944
(612) 205-1753
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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