Organization
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Active
Parent organization
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Other names
San Luis Valley Health Stuart Avenue Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Authorized official
MRS. KONNIE MARTIN (C.E.O.)
(719) 587-1206
Entity
Organization
Contact information
Practice address
2115 STUART AVE, ALAMOSA, CO 81101-2269
(719) 589-3000
(719) 587-1372
Mailing address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-3000
(719) 587-1372
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
011001
CO
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
011001
CO
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11777869
—
CO
Enumeration date
05/19/2006
Last updated
11/24/2020
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