Provider Demographics
NPI:1669932323
Name:SHEPHERD CARE, LLC
Entity type:Organization
Organization Name:SHEPHERD CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUGU
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:YOBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-482-9531
Mailing Address - Street 1:75 BISHOP ST STE 17
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:207-482-9531
Mailing Address - Fax:
Practice Address - Street 1:75 BISHOP ST STE 17
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:207-352-8799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness