NPI 1679299093 · live from the CMS NPI Registry
Riverside Ffk LLC
Behavior Analyst in South Portland, ME. National Provider Identifier 1679299093, active.
NPI record
| NPI | 1679299093 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 53 Tremont St, South Portland, ME 04106 |
| Practice phone | 207-233-2274 |
| Mailing address | 117 Sunset Ave Apt 1, South Portland, ME 04106 |
| Enumerated | October 17, 2022 |
| Last updated | October 17, 2022 |
| Authorized official | Olanrewaju Fashina, Partner 1 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| In Home Supportive Care | 253Z00000X | — |
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.