# VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
- **Other names:** Rio Grande Hospital Clinic at South Fork - Medicaid Only, Rio Grande Hospital Clinic at South Fork, Valley Citizens' Foundation for Health Care Inc
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699266718
- **Legal business name:** VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
- **Authorized official:** JENNY M GALLEGOS (ADMIN SEC/CREDENTIALING)
- **Authorized official phone:** (719) 850-4948

## Contact information

- **Practice address:** 52 JACKSON STREET, SOUTH FORK, CO 81154
- **Practice address phone:** (719) 873-5494
- **Practice address fax:** (719) 873-5488
- **Mailing address:** 310 COUNTY ROAD 14, DEL NORTE, CO 81132-8719
- **Mailing address phone:** (719) 657-2510
- **Mailing address fax:** (719) 657-2511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC0050X | Critical Access Hospital Clinic/Center | — | NULL | Yes |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | — |

## Other

- **Enumeration date:** 05/24/2018
- **Last updated:** 10/05/2026