Provider Demographics
NPI:1245716265
Name:RELIABLE HOME SUPPORT, LLC
Entity type:Organization
Organization Name:RELIABLE HOME SUPPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARIF
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-800-3159
Mailing Address - Street 1:75 BISHOP ST STE 19
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2614
Mailing Address - Country:US
Mailing Address - Phone:207-956-7013
Mailing Address - Fax:
Practice Address - Street 1:75 BISHOP ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2614
Practice Address - Country:US
Practice Address - Phone:207-956-7013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-12
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care