Healthcare Provider Details

I. General information

NPI: 1407843576
Provider Name (Legal Business Name): VALLEY-WIDE HEALTH SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 N HURT ST
CENTER CO
81125
US

IV. Provider business mailing address

128 MARKET ST
ALAMOSA CO
81101-2290
US

V. Phone/Fax

Practice location:
  • Phone: 719-754-2778
  • Fax: 719-754-2166
Mailing address:
  • Phone: 719-587-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateCO

VIII. Authorized Official

Name: JANIA ARNOLDI
Title or Position: PRESIDENT/CEO
Credential:
Phone: 719-589-5161