| San Luis Valley Community Mental Health Center, Inc. | |
|
915 Dahlia Street Antonito CO 81120 | |
| (719) 589-3671 | |
| Not Available |
| Full Name | San Luis Valley Community Mental Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 915 Dahlia Street, Antonito, Colorado |
| Authorized Official Name and Position | Kyle Turnwall (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7195893671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Luis Valley Community Mental Health Center, Inc. 8745 County Road 9 S Alamosa CO 81101-9610 Ph: (719) 589-3671 | San Luis Valley Community Mental Health Center, Inc. 915 Dahlia Street Antonito CO 81120 Ph: (719) 589-3671 |
| NPI Number | 1164249165 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164249165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
San Luis Valley Behavioral Health Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 915 Dahlia, Antonito, CO 81120 Phone: 719-589-3671 Fax: 719-587-6824 |