Healthcare Provider Details

I. General information

NPI: 1548738024
Provider Name (Legal Business Name): DECENT HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 MOUNT VERNON AVE STE 5
AUGUSTA ME
04330-4233
US

IV. Provider business mailing address

41 CATHEDRAL OAKS DR
BIDDEFORD ME
04005-9360
US

V. Phone/Fax

Practice location:
  • Phone: 207-807-9115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. FAYSAL KALAYAF MANAHE
Title or Position: ADMIN
Credential:
Phone: 207-807-9115