Organization
EVENING LIGHT SUPPORTIVE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATHIEU MUTANDA MATANDA (OWNER/DIRECTOR)
(267) 904-0867
Entity
Organization
Contact information
Practice address
151 EAST AVE FL 1, LEWISTON, ME 04240-5666
(267) 904-0867
Mailing address
151 EAST AVE FL 1, LEWISTON, ME 04240-5666
(267) 904-0867
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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