Provider Demographics
NPI:1821524943
Name:ENGILITY ENTERPRISES LLC
Entity Type:Organization
Organization Name:ENGILITY ENTERPRISES LLC
Other - Org Name:ENGILITY ENTERPRISES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARHIYO
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-409-2868
Mailing Address - Street 1:1 COAST LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2844
Mailing Address - Country:US
Mailing Address - Phone:207-776-1709
Mailing Address - Fax:
Practice Address - Street 1:1 COAST LANE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103
Practice Address - Country:US
Practice Address - Phone:207-776-1709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management