MEDICARE: YOSEV HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1043910193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOSEV HOMES LLC

Provider Business Mailing Address
First Line	:	246 AUBURN ST APT 139
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2165
Country	:	US
Telephone Number	:	720-781-4324
Fax Number	:

Provider Business Practice Location Address
First Line	:	246 AUBURN ST APT 139
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2165
Country	:	US
Telephone Number	:	720-781-4324
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. LIONEL NIMA NGAPEY
Credential	:
Telephone Number	:	720-781-4324

Provider Enumeration Date	:	03/07/2023
Last Update Date	:	03/07/2023

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Directions to “YOSEV HOMES LLC ” Practice Location

Language	Start Address	Practice Location

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