Healthcare Provider Details

I. General information

NPI: 1366256810
Provider Name (Legal Business Name): FRIENDLY DAY PROGRAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 MAIN ST
SOUTH PORTLAND ME
04106-5409
US

IV. Provider business mailing address

566 MAIN ST
SOUTH PORTLAND ME
04106-5409
US

V. Phone/Fax

Practice location:
  • Phone: 207-331-0519
  • Fax:
Mailing address:
  • Phone: 207-331-0519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OMAR SOWAMRAH
Title or Position: OWNER
Credential:
Phone: 207-327-9933