This area covers the central-western part of New Brunswick, sharing a border with the state of Maine.

There are more than 40 communities in the Upper River Valley Area including Andover,  Aroostook, Arthurette, Bath, Bedell, Beechwood, Belleville, Bloomfield, Brighton, Bristol, Carlow, Centreville, Cloverdale, Denmark, Florenceville-Bristol, Glassville, Grafton, Greenfield, Hartland, Holmesville, Jacksonville, Johnville, Juniper, Newbridge, Newburg, Northampton, Pembroke, Perth, Perth-Andover, Plaster Rock, Richmond, Simonds, Somerville, Summerfield, Tilley, Neqotkuk (Tobique) First Nation, Victoria, Wakefield, Waterville, Wicklow, Wilmot, and Woodstock.

Horizon has two community health centres in the area, as well as Horizon’s Upper River Valley Hospital in Waterville and Hotel Dieu St. Joseph in Perth Andover.

In the Upper River Valley Area, Community Health Needs Assessments were completed for the Tobique and Perth Andover Area and the Carleton County Area.