Provider Demographics
NPI:1710371729
Name:VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:VALLEY VIEW HOSPITAL ASSOCIATION
Other - Org Name:THE NEUROLOGY CENTER AT VALLEY VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CREVLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-384-6606
Mailing Address - Street 1:1830 BLAKE AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:GLENWOOD SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4275
Mailing Address - Country:US
Mailing Address - Phone:970-384-7144
Mailing Address - Fax:970-384-8115
Practice Address - Street 1:1906 BLAKE AVENUE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4227
Practice Address - Country:US
Practice Address - Phone:970-384-7291
Practice Address - Fax:970-384-7293
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY VIEW HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-27
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO417386Medicare PIN