Organization
SAN LUIS VALLEY COMMUNITY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA ROMERO (CEO)
(719) 589-3671
Entity
Organization
Contact information
Practice address
8745 COUNTY ROAD 9 S, ALAMOSA, CO 81101-9610
(719) 589-3671
(719) 589-9136
Mailing address
8745 COUNTY ROAD 9 SOUTH, ALAMOSA, CO 81101
(719) 589-3671
(719) 589-9136
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
1056-00
CO
251S00000X
Community/Behavioral Health Agency
15K557
CO
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35180358
MEDICAID FEE FOR SERVICE
CO
Enumeration date
03/09/2011
Last updated
01/16/2023
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