Healthcare Provider Details

I. General information

NPI: 1437370277
Provider Name (Legal Business Name): CARE DEVELOPMENT OF MAINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 4TH ST
BANGOR ME
04401-6140
US

IV. Provider business mailing address

PO BOX 923
BANGOR ME
04402-0923
US

V. Phone/Fax

Practice location:
  • Phone: 207-941-2824
  • Fax: 207-941-2845
Mailing address:
  • Phone: 207-941-2824
  • Fax: 207-941-2845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMC9998
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberMC9998
License Number StateME

VIII. Authorized Official

Name: MRS. CYNTHIA MICHELLE PETERSON
Title or Position: CLINICAL SUPERVISOR
Credential: MSW
Phone: 207-941-2824