Organization
DIVINE RESIDENTIAL CARE LLC
Active
Other names
Divine Residential Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. INES UWAMAHORO SR. (CEO)
(207) 400-9368
Entity
Organization
Contact information
Practice address
41 TOWNHOUSE DR, SOUTH PORTLAND, ME 04106-1948
(207) 400-9368
Mailing address
41 TOWNHOUSE DR, SOUTH PORTLAND, ME 04106-1948
(207) 400-9368
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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