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Organization

RED WILLOW, INC

Active
Other names
Willow House
Organization subpart
No

Provider details

NPI number
Authorized official
KINDRA D LAMBERT (GENERAL MANAGER)
(719) 589-5734
Entity
Organization

Contact information

Practice address
183 BROADWAY AVE, ALAMOSA, CO 81101-2801
(719) 589-5734
Mailing address
183 BROADWAY AVE, ALAMOSA, CO 81101-2801
(719) 589-5734

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04183653
CO
Enumeration date
02/26/2007
Last updated
08/22/2020
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