FALLBROOK RESIDENTIAL CARE FACILITY INC. NPI 1477881951

NPI Information

FALLBROOK RESIDENTIAL CARE FACILITY, INC. is an assisted living facility in Portland, ME. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. FALLBROOK RESIDENTIAL CARE FACILITY, INC. NPI is 1477881951. The provider is registered as an organization entity type.

The provider's business location address is:

418 RAY ST
PORTLAND, ME
ZIP 04103-934
Phone: (207) 878-0788

The provider's authorized official is Glen G Cyr .
The authorized official title is Vp Finance and has the following contact phone number (207) 786-3554.

The CLIA number assigned to this NPI record is 20D2245747 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2009 and was last updated on 11/23/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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