Organization
KING AND LORD CARE 'KLC' LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRESOR ELIJAH BEYA (CHIEF EXECUTIVE OFFICER CEO)
(207) 321-1605
Entity
Organization
Contact information
Practice address
501 WESTBROOK STREET 209B, SOUTH PORTLAND, ME 04106
(207) 321-1605
Mailing address
501 WESTBROOK STREET 209B, SOUTH PORTLAND, ME 04106
(207) 321-1605
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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