Provider Demographics
NPI:1043831886
Name:VALTINA, LLC
Entity Type:Organization
Organization Name:VALTINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURICY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-257-3033
Mailing Address - Street 1:9150 COUNTY ROAD 240
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-9216
Mailing Address - Country:US
Mailing Address - Phone:719-257-3033
Mailing Address - Fax:
Practice Address - Street 1:7405 W US HIGHWAY 50 STE 105
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9354
Practice Address - Country:US
Practice Address - Phone:719-257-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health