Provider Demographics
NPI:1396734893
Name:VALLEY-WIDE HEALTH SYSTEMS, INC
Entity type:Organization
Organization Name:VALLEY-WIDE HEALTH SYSTEMS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-589-5161
Mailing Address - Street 1:128 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2290
Mailing Address - Country:US
Mailing Address - Phone:719-587-1001
Mailing Address - Fax:
Practice Address - Street 1:UNIT 1 B AT 233 MAIN STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN LUIS
Practice Address - State:CO
Practice Address - Zip Code:81152-0328
Practice Address - Country:US
Practice Address - Phone:719-672-3352
Practice Address - Fax:719-672-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD0000X
CO261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13984772Medicaid
CO480030OtherDELTA DENTAL