Provider Demographics
NPI:1255202693
Name:PRIORITY RESIDENTIAL SERVICES, LLC
Entity type:Organization
Organization Name:PRIORITY RESIDENTIAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:M
Authorized Official - Last Name:IRAKOZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-831-7021
Mailing Address - Street 1:220 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9568
Mailing Address - Country:US
Mailing Address - Phone:207-831-7021
Mailing Address - Fax:
Practice Address - Street 1:220 PAYNE RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9568
Practice Address - Country:US
Practice Address - Phone:207-831-7021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care