Provider Demographics
NPI:1043817422
Name:PLEDGE RESIDENTIAL CARE
Entity Type:Organization
Organization Name:PLEDGE RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COME - ARISTIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAHOUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-408-7193
Mailing Address - Street 1:720 FORT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-2262
Mailing Address - Country:US
Mailing Address - Phone:207-408-7193
Mailing Address - Fax:
Practice Address - Street 1:720 FORT HILL RD
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-2262
Practice Address - Country:US
Practice Address - Phone:207-408-7193
Practice Address - Fax:207-222-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management