Provider Demographics
NPI:1447643895
Name:VALOR LLC
Entity type:Organization
Organization Name:VALOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLAVIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:505-466-2747
Mailing Address - Street 1:24B WINDSPIRIT RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1442
Mailing Address - Country:US
Mailing Address - Phone:505-466-2747
Mailing Address - Fax:
Practice Address - Street 1:2008 ROSINA ST
Practice Address - Street 2:STE #6
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3271
Practice Address - Country:US
Practice Address - Phone:505-699-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health