Organization
VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
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
Legal business name
VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
Authorized official
JENNY M GALLEGOS (ADMINISTRATIVE SECRETARY/CREDENTIAL)
(719) 850-4948
Entity
Organization
Contact information
Practice address
52 JACKSON STREET, SOUTH FORK, CO 81154
(719) 873-5494
(719) 873-5488
Mailing address
310 COUNTY ROAD 14, DEL NORTE, CO 81132-8719
(719) 657-2510
(719) 657-2511
Taxonomy
Speciality
Code
Description
License number
State
261QC0050X
Critical Access Hospital Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000145177
—
CO
Enumeration date
05/24/2018
Last updated
03/06/2026
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