Provider Demographics
NPI:1114363934
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:719-589-5161
Mailing Address - Fax:719-589-5722
Practice Address - Street 1:10TH AND DAHLIA
Practice Address - Street 2:
Practice Address - City:ANTONITO
Practice Address - State:CO
Practice Address - Zip Code:81120
Practice Address - Country:US
Practice Address - Phone:719-376-5426
Practice Address - Fax:719-376-5880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QR0400X, 261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO75508222Medicaid
COVAC 4808OtherANTHEM
COCE 9669OtherTRAVELERS MEDICARE