Organization
EXCELLER SUPPORT SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN GARNON NISHIMWE (CHIEF EXECUTIVE OFFICER (CEO))
(207) 352-8710
Entity
Organization
Contact information
Practice address
168 LISBON ST FL 2, LEWISTON, ME 04240-7234
(207) 310-3101
Mailing address
168 LISBON ST FL 2, LEWISTON, ME 04240-7234
(207) 310-3101
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
01/09/2023
Last updated
12/24/2024
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