Organization · Type 2 NPI

Fountain Valley Health Care LLC

Psychiatric/Mental Health Nurse Practitioner · Colorado Springs, CO

NPI number 1043074024 Active

Practice location

1520 Verde Dr
Colorado Springs, CO 80910-1931

Call (719) 653-7776 Map

Mailing address

1259 Lake Plaza Dr Ste 270
Colorado Springs, CO 80906-3560

Specialties and licenses

Taxonomy	Code	License
Counselor	101Y00000X	None listed
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	None listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

2 other providers at this address

Bundukamara IncPsychiatric/Mental Health Nurse Practitioner Colorado Springs, CO NPI 1497523054
Fountain Valley Health Care LLCPrimary Care Clinic/Center Colorado Springs, CO NPI 1851170856

Other psychiatric/mental health nurse practitioner providers in Colorado Springs

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NPI record

NPI: 1043074024
Entity type: Organization (Type 2)
Issued: Feb 9, 2024
Last updated: Feb 9, 2024
Status: Active
Subpart: Yes of Fountain Valley Health Care LLC

Other names

Family Success Center Behavioral Health · doing business as

Authorized official

Jacquita Louise Jordan, DNP
Owner
(719) 358-7338

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043074024

Fountain Valley Health Care LLC's National Provider Identifier is 1043074024, issued on Feb 9, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Colorado Springs, CO. The record was last updated on Feb 9, 2024.