| NPI | 1104557776 |
|---|---|
| Doing Business As | VALLEY-WIDE AT SOUTHEAST |
| Entity Type | Organization |
| Authorized Contact | JAVIER MARTINEZ CFO 719-587-1083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2024-05-10 |