Organization
MOUNTAIN FAMILY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUSTIN MOYER (CEO)
(970) 945-2840
Entity
Organization
Contact information
Practice address
1905 BLAKE AVE, SUITE 101, GLENWOOD SPRINGS, CO 81601-4288
(970) 945-2840
(970) 945-2893
Mailing address
2700 GILSTRAP CT STE 230, GLENWOOD SPRINGS, CO 81601-8735
(970) 945-2840
(970) 945-2893
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05600812
—
CO
Enumeration date
07/21/2005
Last updated
06/24/2024
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