| Organization Name: | KATAHDIN VALLEY HEALTH CENTER |
| NPI Number: | 1427433630 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DURWARD L HUMPHREY (CEO) |
| Mailing Address: | 29 Military St Ste B Houlton |
| State: | ME US |
| Postal Code: | 047301713 |
| Phone Number: | 2075282285 |
| Fax Number: | 2075282880 |
| NPI Enumeration Date: | 07/29/2015 |
| NPI Last Update Date: | 07/29/2015 |
| 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: | |