Healthcare Provider Details

I. General information

NPI: 1407584758
Provider Name (Legal Business Name): VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 08/12/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BLAKE AVE
GLENWOOD SPRINGS CO
81601-4227
US

IV. Provider business mailing address

PO BOX 2270
GLENWOOD SPRINGS CO
81602-2270
US

V. Phone/Fax

Practice location:
  • Phone: 970-384-6710
  • Fax: 970-384-7536
Mailing address:
  • Phone: 970-384-6710
  • Fax: 970-384-7536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHARLES CREVLING
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 970-384-6606