Healthcare Provider Details

I. General information

NPI: 1629997283
Provider Name (Legal Business Name): SACOPEE VALLEY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S HIRAM RD
HIRAM ME
04041-3636
US

IV. Provider business mailing address

70 MAIN ST
PORTER ME
04068-3527
US

V. Phone/Fax

Practice location:
  • Phone: 207-625-8126
  • Fax:
Mailing address:
  • Phone: 207-625-8126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LEE EASTMAN
Title or Position: CFO
Credential:
Phone: 207-625-2235