Provider Demographics
NPI:1861496697
Name:LOWER VALLEY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:LOWER VALLEY HOSPITAL ASSOCIATION
Other - Org Name:FAMILY HEALTH WEST HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KORREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-858-2164
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-0130
Mailing Address - Country:US
Mailing Address - Phone:970-858-2186
Mailing Address - Fax:970-858-2208
Practice Address - Street 1:300 W OTTLEY AVE
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-2118
Practice Address - Country:US
Practice Address - Phone:970-858-3900
Practice Address - Fax:970-858-2202
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWER VALLEY HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-09
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2511OC275N00000X
CO0212282NC0060X
COAL-0277310400000X
COAL-0444310400000X
CO0213314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04181780Medicaid
CO05063003Medicaid
CO05653712Medicaid
CO05659131Medicaid
CO06-1302Medicare Oscar/Certification
CO05659131Medicaid