| Organization Name: | SAN LUIS VALLEY BEHAVIORAL HEALTH GROUP |
| NPI Number: | 1063406999 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESSICA L PEREZ (CFO) |
| Mailing Address: | 8745 County Road 9 S Alamosa |
| State: | CO US |
| Postal Code: | 81101 |
| Phone Number: | 7195893671 |
| Fax Number: | 7195891521 |
| NPI Enumeration Date: | 09/07/2005 |
| NPI Last Update Date: | 11/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 0369 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |