San Luis Valley Community Mental Health Center, Inc.
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Monte Vista, CO
NPI 1043047889 · NPPES record last updated Sep 16, 2024
Key facts
- NPI
- 1043047889
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- SAN LUIS VALLEY COMMUNITY MENTAL HEALTH CENTER, INC.
- Practice address
- 402 4TH Ave
Monte Vista, CO 81144-1120 - Phone
- (719) 589-3671
- NPI assigned
- Sep 16, 2024
- Organization subpart
- No
Authorized official
- Name
- Kyle Turnwall
- Title
- Chief Financial Officer
- Phone
- (719) 589-3671
Other NPIs on the same Medicare enrollment 20
Corporate family (same tax ID) 38
Practitioners 7
-
Jamie Bogner, LPC
-
Marcia Candy, LPC, LAC
-
Aaliyah S Duran, LPCC
-
Breanna Mae Mosco, LPCC
-
Ashley Sasser, LPC
-
Adela M Valencia Lucero, LPCC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051025001036 | CO | Part B Supplier - Clinic/Group Practice | 0345267779 |
Receives reassigned benefits from 43 practitioners 20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Alamosa, CO; Antonito, CO; Center, CO; Del Norte, CO; Fort Garland, CO; La Jara, CO; Monte Vista, CO; San Luis, CO… |
National Provider Directory
- Tax ID family
- San Luis Valley Behavioral Health Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
402 4TH Ave
Monte Vista, CO 81144-1120
Mailing address
8745 County Road 9 S
Alamosa, CO 81101-9610
Phone (719) 589-3671
Other names
- San Luis Valley Behavioral Health Group
Other providers in Monte Vista, CO
- Bryan J. Salazar
- San Juan Youth Works
- San Luis Valley Community Mental Health Center
- San Luis Valley Community Mental Health Center
- San Luis Valley Community Mental Health Center
- Carly Jo Santi Lozoya
- Richard Donald Santi
- Sargent School District Re 33J
- Deanna Shepherd
- Patrick Raymond Sparks
All providers in Monte Vista, CO · Mental Health Clinic/Center (Including Community Mental Health Center) in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.