Organization
LUIS ALVAREZ LLC
Active
Other names
Western Mountain Youth Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS ANTONIO ALVAREZ MA (DIRECTOR)
(719) 852-9697
Entity
Organization
Contact information
Practice address
922 2ND AVE, MONTE VISTA, CO 81144-1443
(719) 852-9697
Mailing address
922 2ND AVE, MONTE VISTA, CO 81144-1443
(719) 852-9697
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1593695
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56481322
—
CO
Enumeration date
07/29/2010
Last updated
07/29/2010
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