Fountain Valley Health Care Llc
LBN: Fountain Valley Health Care Llc
Fountain Valley Health Care Llc is an health care organization with primary practice located at 1259 Lake Plaza Dr Ste 270 , Colorado Springs CO 80906-3560. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Fountain Valley Health Care Llc can be contacted via phone (719) 271-2887, or through Jordan, Jacquita via phone (719) 271-2887.
Contact Information
Primary practice address
1259 Lake Plaza Dr Ste 270
Colorado Springs CO 80906-3560
Phone: (719) 271-2887
Fax:
Website:
Authorized official contact:
Name: Jordan, Jacquita Family Nurse Practitioner (FNP)
Phone: (719) 271-2887
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X |
Profile Details
| NPI number | 1275272924 |
|---|---|
| LBN Legal business name | Fountain Valley Health Care Llc |
| DBA Doing business as | |
| Authorized official | Jordan, Jacquita Family Nurse Practitioner (FNP) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 1st, 2022 |
| Last updated | Oct 18th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275272924 | NPPES |
| Colorado | MEDICAID | 9000205225 |
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