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General NPI Number Information
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NPI Number | 1811707474
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Entity Type | Organization
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Legal Business Name | NR MAINE LLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 295 KENNEDY MEMORIAL DR
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City | WATERVILLE
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State | ME
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Zip | 04901-4535
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Country | US
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Telephone | 800-743-6802
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 FRANCE AVE S STE 350
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City | EDINA
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State | MN
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Zip | 55435-1810
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Country | US
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Telephone | 800-388-5150
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Fax |
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Authorized Official
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Title or Position | VP & SR. ASST GENERAL COUNSEL
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Name | MARY PATRICIA RODENBERG-ROBERTS
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Credential |
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Telephone | 952-836-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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