Provider Demographics
NPI:1881436327
Name:KUJALI LLC
Entity type:Organization
Organization Name:KUJALI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TOUSSAINT
Authorized Official - Middle Name:
Authorized Official - Last Name:BYEMBA KILONGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-630-9798
Mailing Address - Street 1:62 PORTLAND RD STE 25A
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6650
Mailing Address - Country:US
Mailing Address - Phone:626-630-9798
Mailing Address - Fax:
Practice Address - Street 1:306 PINE ST APT 2
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6309
Practice Address - Country:US
Practice Address - Phone:626-630-9798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities