| Organization Name: | NORTHERN MAINE GENERAL |
| NPI Number: | 1942411319 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REYNOLD RAYMOND (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 3400 Aroostook Rd Eagle Lake |
| State: | ME US |
| Postal Code: | 047390310 |
| Phone Number: | 2074445152 |
| Fax Number: | 2074446099 |
| NPI Enumeration Date: | 05/25/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320800000X |
| License Number: | 439379 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |