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Active NPI 1205651700 Organization (Entity Type 2)

Genesis Support Solution Llc

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities • Windham, ME

About Genesis Support Solution Llc NPI 1205651700 Summary

Genesis Support Solution Llc is a verified healthcare organization specializing in Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities operating in Windham, ME. Located at 6 HARPERS WAY, this facility provides patient care and medical services under National Provider Identifier (NPI) 1205651700.

Administrative operations and authorized compliance are overseen by Brandy Kibamba (Managing Member).

Facility Location & Contact Primary Location

Facility Address

6 Harpers Way

Windham, ME 040626940

Telephone 8046658185

Authorized Official Information

Authorized Contact Name

Brandy Kibamba

Title / Role

Managing Member

Official Telephone

8046658185

Facility Classifications & Specialties

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities Primary Taxonomy

NUCC Taxonomy Code: 320900000X

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

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active November 19, 2024

NPI status registered as active in NPPES database

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Updated Practice Location November 19, 2024

Registered at 6 HARPERS WAY, WINDHAM, ME 040626940 (Tel: 8046658185)

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Updated Business Mailing Address November 19, 2024

Registered at 6 HARPERS WAY, WINDHAM, ME 040626940

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Organization / Clinic Name Updated November 19, 2024

Operating as GENESIS SUPPORT SOLUTION LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 19, 2024

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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Initial NPI Registration & Enumeration November 19, 2024

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1205651700
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: November 19, 2024
Last Update: November 19, 2024

Mailing Address

6 Harpers Way

Windham, ME 040626940

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.