Healthcare Provider Details

I. General information

NPI: 1801775853
Provider Name (Legal Business Name): AMAHORO RESIDENTIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 WHITE ST
LEWISTON ME
04240-6727
US

IV. Provider business mailing address

19 WHITE ST
LEWISTON ME
04240-6727
US

V. Phone/Fax

Practice location:
  • Phone: 202-790-1796
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: AUBIN HIRWA
Title or Position: MANAGER
Credential:
Phone: 202-790-1796