Organization
VALLEY-WIDE HEALTH SYSTEMS, INC
Active
Other names
Edward M. Kennedy Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JANIA ARNOLDI (PRESIDENT/CEO)
(719) 589-5161
Entity
Organization
Contact information
Practice address
925 2ND AVE, MONTE VISTA, CO 81144-1432
(719) 852-2512
(719) 852-3923
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
05
—
56836074
—
CO
01
—
CE 9669
TRAVELERS MEDICARE NUMBER
CO
01
—
VAC 4808
ANTHEM BCBS
CO
Enumeration date
10/04/2005
Last updated
04/30/2024
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