Organization
NORTHERN MAINE GENERAL
Active
Other names
Floyd Powell 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
38 CARTER ST, 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 2225
ME
Other
Enumeration date
05/25/2007
Last updated
08/22/2020
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