| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 92 Bennett Drive, Caribou, Maine |
| Authorized Official Name and Position | Reynold Raymond (CEO) |
| Authorized Official Contact | 2074445152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3388 Aroostook Road Eagle Lake ME 04739-0310 Ph: (207) 444-5152 | 92 Bennett Drive Caribou ME 04736 Ph: (207) 444-5152 |
| NPI Number | 1821327982 |
|---|---|
| Provider Enumeration Date | 12/18/2009 |
| Last Update Date | 12/18/2009 |
| Medicare PECOS PAC ID | 4981512530 |
|---|---|
| Medicare Enrollment ID | O20110510000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821327982 | NPI | - | NPPES |
| 102850500 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 439379 (Maine) | Primary |
| Provider Name | Esther E Cyr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609934678 PECOS PAC ID: 6305746413 Enrollment ID: I20040113000430 |
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