OrganizationActive
Covenant Residential Services LLC
NPI 1568167708 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · South Portland, ME
Provider details
- NPI number
- 1568167708
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Zabron Ndikumukiza, Managing Director(207) 252-8470
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
696 Westbrook St Apt 13a
South Portland, ME 04106-1987
Phone: (207) 252-8470
Approximate (ZIP-level) locationGet directions
Mailing address
696 Westbrook St Apt 13a
South Portland, ME 04106-1987
Registry dates
- Enumerated
- 2023-04-04
- Last updated
- 2023-04-04
- Certified
- 2023-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.