Healthcare Provider Details

I. General information

NPI: 1609788967
Provider Name (Legal Business Name): VALLEY-WIDE HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 BARNES AVE
LA JUNTA CO
81050-2138
US

IV. Provider business mailing address

128 MARKET ST
ALAMOSA CO
81101-2290
US

V. Phone/Fax

Practice location:
  • Phone: 719-384-5446
  • Fax:
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 State

VIII. Authorized Official

Name: LISA CHAVEZ
Title or Position: FINANCE PROJECT ANALYST
Credential:
Phone: 719-383-5445