NPIMap

Organization Active NPI

Northern Maine General

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Eagle Lake, ME
National Provider Identifier
1114166394
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
NORTHERN MAINE GENERAL
Practice address
3388 Aroostook Road
Eagle Lake, ME 04739-0310
Phone
(207) 444-5152
Fax
(207) 444-6099
NPI assigned
Feb 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Reynold Raymond
Title
Ceo
Phone
(207) 444-5152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

3388 Aroostook Road
Eagle Lake, ME 04739-0310

Mailing address

46 Fords LN
Mapleton, ME 04757-4324
Phone (207) 444-5152

Other identifiers 1

IdentifierTypeStateIssuer
102850410MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Northern Maine General16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1114166394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 FORDS LN",
            "city": "MAPLETON",
            "state": "ME",
            "postal_code": "047574324",
            "telephone_number": "207-444-5152",
            "fax_number": "207-444-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3388 AROOSTOOK ROAD",
            "city": "EAGLE LAKE",
            "state": "ME",
            "postal_code": "047390310",
            "telephone_number": "207-444-5152",
            "fax_number": "207-444-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE GENERAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "REYNOLD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-444-5152",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102850410",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Lake, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.