Organization
NORTHERN MAINE GENERAL
Active
Other names
CHILDREN'S BEHAVIORAL HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
REYNOLD RAYMOND (CEO)
(207) 444-5152
Entity
Organization
Contact information
Practice address
92 BENNETT DRIVE, CARIBOU, ME 04736
(207) 444-5152
(207) 444-6099
Mailing address
3388 AROOSTOOK ROAD, EAGLE LAKE, ME 04739-0310
(207) 444-5152
(207) 444-6099
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
439379
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102850500
—
ME
Enumeration date
12/18/2009
Last updated
12/18/2009
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