Organization Name: | KATAHDIN VALLEY HEALTH CENTER |
NPI Number: | 1184794299 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DURWARD L HUMPHREY (CEO) |
Mailing Address: | 40 Court St Houlton |
State: | ME US |
Postal Code: | 047302002 |
Phone Number: | 2075282285 |
Fax Number: | 2085282880 |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 05/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |