# FOUNTAIN VALLEY HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FOUNTAIN VALLEY HEALTH CARE LLC
- **Other names:** Fountain Valley Behavioral Health
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225890619
- **Legal business name:** FOUNTAIN VALLEY HEALTH CARE LLC
- **Authorized official:** JACQUITA LOUISE JORDAN DNP (OWNER)
- **Authorized official phone:** (719) 358-7338

## Contact information

- **Practice address:** 5115 FONTAINE BLVD, FOUNTAIN, CO 80817-1061
- **Practice address phone:** (719) 653-7776
- **Mailing address:** 10265 ROLLING RIDGE RD, COLORADO SPRINGS, CO 80925-9509
- **Mailing address phone:** (719) 653-7776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/30/2024
- **Last updated:** 06/26/2026