Provider Demographics
NPI:1023172145
Name:IAM-3RIVERS
Entity type:Organization
Organization Name:IAM-3RIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-831-1463
Mailing Address - Street 1:PO BOX 1280
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04098-1280
Mailing Address - Country:US
Mailing Address - Phone:207-523-5170
Mailing Address - Fax:207-854-1787
Practice Address - Street 1:2 HILLSIDE RD
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-4459
Practice Address - Country:US
Practice Address - Phone:207-866-3769
Practice Address - Fax:207-866-3769
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:3RIVERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-21
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320900000X
ME36469315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities