Organization · Type 2 NPI

Golden Group Home Services, LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Gorham, ME

NPI number 1396390811 Active

Practice location

28 State St Ste 4
Gorham, ME 04038-1147

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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NPI record

NPI: 1396390811
Entity type: Organization (Type 2)
Issued: Aug 2, 2019
Last updated: May 31, 2021
Status: Active

Other names

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Limited Liability Company (llc) · other name
Limited Liability Company (llc) · other name

Authorized official

Mr. Michel Kanyambo
Chief Executive Officer
(207) 415-5393

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About NPI 1396390811

Golden Group Home Services, LLC's National Provider Identifier is 1396390811, issued on Aug 2, 2019. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Gorham, ME. The record was last updated on May 31, 2021.