Organization
RED WILLOW, INC
Active
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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