MEDICARE: REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1750670998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC

Provider Business Mailing Address
First Line	:	PO BOX 8691
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-8691
Country	:	US
Telephone Number	:	325-372-5701
Fax Number	:	325-372-3249

Provider Business Practice Location Address
First Line	:	403 W WALLACE ST
Second Line	:
City	:	SAN SABA
State	:	TX
Zip	:	76877-4433
Country	:	US
Telephone Number	:	325-372-5701
Fax Number	:	325-372-3249

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DEBBIE BREWER
Credential	:
Telephone Number	:	615-465-7626

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	03/28/2011

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