KENNEDY WAIVER HOME
NPI 1912108168
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Eagle Lake, ME

Q: What is Northern Maine General's NPI number?

The NPI number for Northern Maine General is 1912108168. It was assigned to this organization in the NPPES registry on May 29, 2007. The provider is doing business as Kennedy Waiver Home.

Q: What is Northern Maine General's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Active since May 29, 2007

31 DEVOE BROOK RD, EAGLE LAKE, ME 04739(207) 444-5152(207) 444-6099 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kennedy Waiver Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEDY WAIVER HOME (NPI 1912108168) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Eagle Lake, Maine and active in the NPI registry since May 2007. The organization lists Reynold Raymond, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1912108168

Entity TypeOrganization

Primary Taxonomy320600000X

Legal Business NameNORTHERN MAINE GENERAL

Location Address31 DEVOE BROOK RDEagle Lake, ME 04739-0310

Mailing AddressPo Box 310Eagle Lake, ME 04739-0310 · (207) 444-5152 · Fax (207) 444-6099

Phone(207) 444-5152

Fax(207) 444-6099

Organization SubpartNo

Authorized OfficialReynold RaymondChief Executive Officer · (207) 444-5152

Enumeration DateMay 29, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1912108168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320600000X

License✔ Licensed in ME · ALLS 2226

Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

31 DEVOE BROOK RD, Eagle Lake, ME 04739

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Other Names 1

Doing Business AsKennedy Waiver Home

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northern Maine General's NPI number?

The NPI number for Northern Maine General is 1912108168. It was assigned to this organization in the NPPES registry on May 29, 2007. The provider is doing business as Kennedy Waiver Home.

Where is Northern Maine General located?

Northern Maine General is located at 31 Devoe Brook Rd, Eagle Lake, ME 04739. The listed phone number is (207) 444-5152.

What is Northern Maine General's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Northern Maine General was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.