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Organization

GRACEFUL RESIDENTIAL SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EGIDE SIMBARE MBA-HCM (CEO)
(207) 618-0881
Entity
Organization

Contact information

Practice address
10 BURNHAM ST APT 5, SOUTH PORTLAND, ME 04106-4245
(207) 618-0881
Mailing address
10 BURNHAM ST APT 5, SOUTH PORTLAND, ME 04106-4245
(207) 618-0881

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
09/25/2023
Last updated
09/25/2023
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