Provider Demographics
NPI:1194521187
Name:ALEGRIA COMMUNITY SUPPORT LLC
Entity type:Organization
Organization Name:ALEGRIA COMMUNITY SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:APHY
Authorized Official - Middle Name:MATUTU WA ZINU
Authorized Official - Last Name:NSIBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-594-5404
Mailing Address - Street 1:22 SANCHO DR
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-8831
Mailing Address - Country:US
Mailing Address - Phone:202-594-5404
Mailing Address - Fax:
Practice Address - Street 1:22 SANCHO DR
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-8831
Practice Address - Country:US
Practice Address - Phone:202-594-5404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities