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LIMITED LIABILITY COMPANY (LLC)
NPI 1396390811
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Gorham, ME

Active since August 02, 2019
28 STATE ST STE 4, GORHAM, ME 04038(207) 415-5393 Get Directions Write a Review

NPPES record last updated: May 31, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 31, 2021, Aug 2, 2019 (2 updates tracked since 2019).

About Limited Liability Company (llc) NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIMITED LIABILITY COMPANY (LLC) (NPI 1396390811) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Gorham, Maine and active in the NPI registry since August 2019. The organization lists Michel Kanyambo, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1396390811
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameGOLDEN GROUP HOME SERVICES, LLC
Location Address28 STATE ST STE 4Gorham, ME 04038-1147
Mailing Address28 State St Ste 4Gorham, ME 04038-1147 · (207) 415-5393
Phone(207) 415-5393
Organization SubpartNo
Authorized OfficialMichel KanyamboChief Executive Officer · (207) 415-5393
Enumeration DateAugust 2, 2019
Last NPPES UpdateMay 31, 20212 updates tracked since enumeration
NPPES CertifiedMay 31, 2021
✔ NPI 1396390811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

28 STATE ST STE 4, Gorham, ME 04038
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Other Names 1

Other NameLimited Liability Company (llc)

Frequently Asked Questions

What is GOLDEN GROUP HOME SERVICES, LLC's NPI number?

The NPI number assigned to this healthcare provider is 1396390811, enumerated as an "organization" on August 02, 2019.

Where is the provider located?

The provider is located at 28 STATE ST STE 4 GORHAM, ME 04038 and the phone number is (207) 415-5393.

What is the provider's specialty?

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.