NPIMap

Organization Active NPI

Northern Maine General

Doing business as Children's Behavioral Health

  • Community/Behavioral Health Agency
  • Caribou, ME
National Provider Identifier
1821327982
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
439379 Issued in ME
Legal business name
NORTHERN MAINE GENERAL
Doing business as
Children's Behavioral Health
Practice address
92 Bennett Drive
Caribou, ME 04736
Phone
(207) 444-5152
Fax
(207) 444-6099
NPI assigned
Dec 18, 2009
Last updated
Dec 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 439379 ME Primary

Addresses

Primary practice location

92 Bennett Drive
Caribou, ME 04736

Mailing address

3388 Aroostook Road
Eagle Lake, ME 04739-0310
Phone (207) 444-5152

Other identifiers 1

IdentifierTypeStateIssuer
102850500MedicaidME

Other names 1

  • CHILDREN'S BEHAVIORAL HEALTH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110510000052 ME Part B Supplier - Clinic/Group Practice 4981512530 Receives reassigned benefits from 1 practitioner
Practice locations: Eagle Lake, ME

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

92 Bennett Dr
Caribou, ME 04736
Phone (207) 492-1036

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1821327982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BENNETT DRIVE",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "04736",
            "telephone_number": "207-444-5152",
            "fax_number": "207-444-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE GENERAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2009-12-18",
        "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"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "439379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102850500",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHILDREN'S BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caribou, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.