Organization
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Active
Other names
San Luis ValleyHealth Monte Vista Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KONNI MARTIN (CEO)
(719) 587-1206
Entity
Organization
Contact information
Practice address
103 CHICO CT, MONTE VISTA, CO 81144-1065
(719) 852-9400
(719) 852-9311
Mailing address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-2511
(719) 587-1372
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
011001
CO
207Q00000X
Family Medicine Physician
Primary
011001
CO
2084P0800X
Psychiatry Physician
011001
CO
363A00000X
Physician Assistant
011001
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000144694
—
CO
Enumeration date
12/16/2014
Last updated
05/26/2023
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