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General NPI Number Information
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NPI Number | 1023172145
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Entity Type | Organization
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Legal Business Name | IAM-3RIVERS
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 2 HILLSIDE RD
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City | ORONO
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State | ME
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Zip | 04473-4459
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Country | US
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Telephone | 207-866-3769
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Fax | 207-866-3769
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Provider Business Mailing Address
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Address Line | PO BOX 1280
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City | WESTBROOK
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State | ME
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Zip | 04098-1280
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Country | US
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Telephone | 207-523-5170
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Fax | 207-854-1787
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Authorized Official
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Title or Position | CEO
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Name | MS. ANN-MARIE MAYBERRY
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Credential |
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Telephone | 207-831-1463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 36469
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License Number State | ME
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