Provider Demographics
NPI:1194515221
Name:HABITAT CARE LLC
Entity type:Organization
Organization Name:HABITAT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAOD
Authorized Official - Middle Name:T
Authorized Official - Last Name:GEBREYEWHANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-239-5919
Mailing Address - Street 1:PO BOX 1311
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04104-1311
Mailing Address - Country:US
Mailing Address - Phone:207-239-5919
Mailing Address - Fax:
Practice Address - Street 1:7 ELIZABETH RD APT 4
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2582
Practice Address - Country:US
Practice Address - Phone:207-239-5919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care