Provider Demographics
NPI:1922818186
Name:RED SEA HOMECARE
Entity type:Organization
Organization Name:RED SEA HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:HERSI
Authorized Official - Last Name:GALAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-344-8651
Mailing Address - Street 1:50 FAIRMOUNT ST APT 16
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-4423
Mailing Address - Country:US
Mailing Address - Phone:207-344-8156
Mailing Address - Fax:
Practice Address - Street 1:50 FAIRMOUNT ST APT 16
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-4423
Practice Address - Country:US
Practice Address - Phone:207-344-8156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities