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
36 CARTER STREET, EAGLE LAKE, ME 04739
(207) 444-5152
(207) 444-6099
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102850200
—
ME
05
—
102850401
—
ME
Enumeration date
02/11/2009
Last updated
02/11/2009
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