| Organization Name: | LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY |
| NPI Number: | 1194792762 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HENRY L. GARVIN (CCH CEO) |
| Mailing Address: | 19021 Us Highway 285 La Jara |
| State: | CO US |
| Postal Code: | 81140 |
| Phone Number: | 7192745121 |
| Fax Number: | 7192746003 |
| NPI Enumeration Date: | 03/02/2006 |
| NPI Last Update Date: | 08/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC0050X |
| License Number: | 011020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Critical Access Hospital |
| Taxonomy Definition: | An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |