Organization
EXCELLENT RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MORRIS BUTSITSI DSP (OPERATIONS MANAGER)
(704) 777-2188
Entity
Organization
Contact information
Practice address
60 WOODLAND RD APT B5, CAPE ELIZABETH, ME 04107-1259
(704) 777-2188
Mailing address
60 WOODLAND RD APT B5, CAPE ELIZABETH, ME 04107-1259
(704) 777-2188
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/12/2020
Last updated
12/12/2020
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