Organization
SUPREME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUKIZA GLOIRE SHAMARAGWE (CEO)
(515) 771-6546
Entity
Organization
Contact information
Practice address
510 CUMBERLAND AVE UNIT 302, PORTLAND, ME 04101-7208
(515) 771-6546
Mailing address
510 CUMBERLAND AVE UNIT 302, PORTLAND, ME 04101-7208
(515) 771-6546
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/04/2025
Last updated
07/04/2025
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