Provider Demographics
NPI:1215403589
Name:SHEKINAH FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:SHEKINAH FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARCISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGISHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-618-3784
Mailing Address - Street 1:238 AUBURN ST APT A4
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2147
Mailing Address - Country:US
Mailing Address - Phone:207-618-3784
Mailing Address - Fax:
Practice Address - Street 1:15 CONSTITUTION DR STE 1A
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6002
Practice Address - Country:US
Practice Address - Phone:207-618-3784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care