Organization
VALLEY-WIDE HEALTH SYSTEMS, INC
Active
Other names
La Jara Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JANIA ARNOLDI (PRESIDENT/CEO)
(719) 589-5161
Entity
Organization
Contact information
Practice address
421 WALNUT STREET, LA JARA, CO 81140
(719) 274-8948
(719) 274-8950
Mailing address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 587-1001
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280030
DELTA DENTAL
CO
Enumeration date
10/18/2005
Last updated
05/10/2024
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