| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 24 Balsam Dr, Millinocket, Maine |
| Authorized Official Name and Position | Nicole Morrison (CEO) |
| Authorized Official Contact | 2077946700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 819 Millinocket ME 04462-0819 Ph: (207) 794-6700 | 24 Balsam Dr Millinocket ME 04462 Ph: (207) 794-6700 |
| NPI Number | 1760640189 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 08/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760640189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Katahdin Valley Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Summer St, Millinocket, ME 04462 Phone: 207-723-6565 Fax: 207-723-6564 | |