Organization
FOUNTAIN VALLEY HEALTH CARE LLC
Active
Parent organization
FOUNTAIN VALLEY HEALTH CARE LLC
Other names
Family Success Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUNTAIN VALLEY HEALTH CARE LLC
Authorized official
JACQUITA LOUISE JORDAN DNP (OWNER)
(719) 653-7776
Entity
Organization
Contact information
Practice address
1520 VERDE DR, COLORADO SPRINGS, CO 80910-1931
(719) 653-7776
Mailing address
1259 LAKE PLAZA DR STE 270, COLORADO SPRINGS, CO 80906-3560
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us