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NPI 1780272252

NPI 1780272252 : HOPE RESIDENTIAL HOMES LLC : WESTBROOK, ME

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General NPI Number Information
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    NPI Number           |    1780272252
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    Entity Type          |    Organization 
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    Legal Business Name  |    HOPE RESIDENTIAL HOMES LLC 
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Dates
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    Enumeration Date     |    01/09/2021
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    Last Update Date     |    01/09/2021
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Provider Practice Location Address
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    Address Line         |    5 WEBB ST APT E 
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    City                 |    WESTBROOK
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    State                |    ME
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    Zip                  |    04092-2943
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    Country              |    US
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    Telephone            |    207-518-1496
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5 WEBB ST APT E 
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    City                 |    WESTBROOK
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    State                |    ME
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    Zip                  |    04092-2943
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    Country              |    US
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    Telephone            |    207-518-1496
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CFO
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    Name                 |    MR. FAUSTIN  NTAGANZWA 
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    Credential           |    DSP
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    Telephone            |    207-518-1496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    320900000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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    License Number       |    
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    License Number State |    
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