Healthcare Provider Details

I. General information

NPI: 1194799023
Provider Name (Legal Business Name): NEW ENGLAND REHABILITATION HOSPITAL OF PORTLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 BRIGHTON AVE STE 201
PORTLAND ME
04102-2374
US

IV. Provider business mailing address

9001 LIBERTY PKWY
BIRMINGHAM AL
35242-7509
US

V. Phone/Fax

Practice location:
  • Phone: 207-775-4000
  • Fax: 207-662-8446
Mailing address:
  • Phone: 205-970-5735
  • Fax: 205-969-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number34370
License Number StateME

VIII. Authorized Official

Name: MR. CAREY B MCRAE
Title or Position: VICE PRESIDENT
Credential:
Phone: 205-970-3442