Organization
DIRIGO RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE MAZAMBO (CEO)
(207) 409-2798
Entity
Organization
Contact information
Practice address
1500 FOREST AVE APT 7D, PORTLAND, ME 04103-1840
(207) 409-2798
Mailing address
1500 FOREST AVE APT 7D, PORTLAND, ME 04103-1840
(207) 409-2798
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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