Provider Demographics
NPI:1043028590
Name:HOME LIKE LIVING CENTER LLC
Entity type:Organization
Organization Name:HOME LIKE LIVING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN MARIE CLAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-766-1634
Mailing Address - Street 1:191 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5303
Mailing Address - Country:US
Mailing Address - Phone:207-766-1634
Mailing Address - Fax:
Practice Address - Street 1:191 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5303
Practice Address - Country:US
Practice Address - Phone:207-766-1634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty