Provider Demographics
NPI:1679634802
Name:VALLEY VIEW HOSPITAL ACUTE INPATIENT REHAB
Entity Type:Organization
Organization Name:VALLEY VIEW HOSPITAL ACUTE INPATIENT REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-945-6535
Mailing Address - Street 1:PO BOX 1970
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-1970
Mailing Address - Country:US
Mailing Address - Phone:970-384-4270
Mailing Address - Fax:970-947-5556
Practice Address - Street 1:1906 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4227
Practice Address - Country:US
Practice Address - Phone:970-384-4270
Practice Address - Fax:970-947-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05075007Medicaid
CO06T075Medicare ID - Type Unspecified