OrganizationActive
Dirigo Residential Care LLC
NPI 1285438283 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Portland, ME
Provider details
- NPI number
- 1285438283
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Dominique Mazambo, Ceo(207) 409-2798
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
1500 Forest Ave Apt 7d
Portland, ME 04103-1840
Phone: (207) 409-2798
Approximate (ZIP-level) locationGet directions
Mailing address
1500 Forest Ave Apt 7d
Portland, ME 04103-1840
Registry dates
- Enumerated
- 2025-04-01
- Last updated
- 2025-04-01
- Certified
- 2025-04-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.