Provider Demographics
NPI:1700626926
Name:COMPASSION RESIDENTIAL SAFE CARE
Entity type:Organization
Organization Name:COMPASSION RESIDENTIAL SAFE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VEMAKONDOLO
Authorized Official - Middle Name:DILU
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-332-5488
Mailing Address - Street 1:100 LYMAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3035
Mailing Address - Country:US
Mailing Address - Phone:207-332-5488
Mailing Address - Fax:
Practice Address - Street 1:61 SPRING ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3904
Practice Address - Country:US
Practice Address - Phone:207-332-5488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility