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Organization
NORTHERN MAINE GENERAL
Active
Organization
NORTHERN MAINE GENERAL
Active
Other names
Brooks Waiver Home
Organization subpart
No
Provider details
NPI number
Authorized official
REYNOLD RAYMOND (CHIEF EXECUTIVE OFFICER)
(207) 444-5152
Entity
Organization
Contact information
Practice address
3358 AROOSTOOK RD, EAGLE LAKE, ME 04739-0310
(207) 444-5152
(207) 444-6099
Mailing address
PO BOX 310, EAGLE LAKE, ME 04739-0310
(207) 444-5152
(207) 444-6099
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
ALLS 2224
ME
Other
Enumeration date
05/25/2007
Last updated
08/22/2020
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