Organization
PALMS RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK KIFOKIE MULONDA (CHIEF EXECUTIVE OFFICER)
(978) 620-8376
Entity
Organization
Contact information
Practice address
1500 FOREST AVE APT 13D, PORTLAND, ME 04103-1846
(978) 620-8376
Mailing address
1500 FOREST AVE APT 13D, PORTLAND, ME 04103-1846
(978) 620-8376
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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