Organization
KATAHDIN VALLEY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDETTE G HUMPHREY (CEO)
(207) 528-2285
Entity
Organization
Contact information
Practice address
30 HOULTON ST, PATTEN, ME 04765-3035
(207) 528-2285
(207) 528-2880
Mailing address
529 S PATTEN RD, PATTEN, ME 04765-3007
(207) 528-2285
(207) 528-2880
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030175
ANTHEM GROUP
ME
01
—
144828
AETNA GROUP
ME
05
—
168260100
—
ME
Enumeration date
01/02/2006
Last updated
12/20/2016
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