Organization
SURE RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DJUMA MBALASSA DSP (CEO)
(207) 618-2857
Entity
Organization
Contact information
Practice address
43 SHEPHERD LN, PORTLAND, ME 04103-1674
(207) 618-2857
Mailing address
43 SHEPHERD LN, PORTLAND, ME 04103-1674
(207) 618-2857
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/20/2021
Last updated
06/20/2021
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