Organization
NORTHERN MAINE GENERAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REYNOLD RAYMOND (CEO)
(207) 444-5152
Entity
Organization
Contact information
Practice address
3388 AROOSTOOK ROAD, EAGLE LAKE, ME 04739-0310
(207) 444-5152
(207) 444-6099
Mailing address
46 FORDS LN, MAPLETON, ME 04757-4324
(207) 444-5152
(207) 444-6099
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102850410
—
ME
Enumeration date
02/12/2009
Last updated
02/12/2009
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