Organization
FIDELIS RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BISENGIMANA GAKUNZI (DIRECTOR OF FINANCE)
(207) 213-9053
Entity
Organization
Contact information
Practice address
54 RUNNING SPRINGS RD, GORHAM, ME 04038-1633
(207) 213-9053
Mailing address
54 RUNNING SPRINGS RD, GORHAM, ME 04038-1633
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/30/2022
Last updated
12/30/2022
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