Organization
PEAK VISTA COMMUNITY HEALTH CENTERS
Active
Parent organization
PEAK VISTA COMMUNITY HEALTH CENTERS
Other names
Health Center at Divide
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEAK VISTA COMMUNITY HEALTH CENTERS
Authorized official
RYAN SPILLANE (CHIEF FINANCIAL OFFICER)
(719) 344-7135
Entity
Organization
Contact information
Practice address
34 HYBROOK RD SOUTH, DIVIDE, CO 80814
(719) 632-5700
(719) 687-4457
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917
(719) 632-5700
(719) 344-7865
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05638267
—
CO
05
—
87322323
—
CO
Enumeration date
11/29/2010
Last updated
03/06/2023
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