Red Willow, Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

RED WILLOW, INC

Doing business as

Willow House

Practice address

183 Broadway Ave
Alamosa, CO 81101-2801

Phone

(719) 589-5734

NPI assigned

Feb 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kindra D Lambert

Title

General Manager

Phone

(719) 589-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willow House Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841326840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 BROADWAY AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012801",
            "telephone_number": "719-589-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 BROADWAY AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012801",
            "telephone_number": "719-589-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED WILLOW, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "KINDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "719-589-5734"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04183653",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Exclusive Provider Organization in Alamosa, CO
• Providers in Alamosa, CO by specialty
• Exclusive Provider Organization in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.