Organization
PINERIDGE SUPPORT AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED MOHAMED (CEO)
(207) 601-2078
Entity
Organization
Contact information
Practice address
34 TALL PINES DR APT 7, LEWISTON, ME 04240-3280
(207) 601-2078
Mailing address
34 TALL PINES DR APT 7, LEWISTON, ME 04240-3280
(207) 601-2078
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/12/2026
Last updated
01/20/2026
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