Organization
COLORADO DEPARTMENT OF CORRECTIONS
Active
Parent organization
STATE OF COLORADO
Other names
LaVista Correctional Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF COLORADO
Authorized official
DR. RANDOLPH MAUL MD (CHIEF MEDICAL OFFICER)
(719) 306-2821
Entity
Organization
Contact information
Practice address
1401 W 17TH ST, PUEBLO, CO 81003-1929
(719) 583-5851
(719) 583-5852
Mailing address
PO BOX 3, LVCF MEDICAL, PUEBLO, CO 81002
(719) 583-5851
(719) 583-5852
Taxonomy
Speciality
Code
Description
License number
State
261QP2400X
Prison Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/24/2025
Last updated
07/14/2025
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