Healthcare Provider Details

I. General information

NPI: 1427181486
Provider Name (Legal Business Name): SEBASTICOOK VALLEY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 MAIN STREET
UNITY ME
04988-0000
US

IV. Provider business mailing address

PO BOX 172
UNITY ME
04988-0172
US

V. Phone/Fax

Practice location:
  • Phone: 207-948-2100
  • Fax: 207-948-3018
Mailing address:
  • Phone: 207-948-2100
  • Fax: 207-948-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RANDALL CLARK
Title or Position: PRESIDENT
Credential:
Phone: 207-487-4000