| Fountain Valley Health Care Llc | |
|
5115 Fontaine Blvd Fountain CO 80817-1061 | |
| (719) 653-7776 | |
| Not Available |
| Full Name | Fountain Valley Health Care Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 5115 Fontaine Blvd, Fountain, Colorado |
| Authorized Official Name and Position | Jacquita Louise Jordan (OWNER) |
| Authorized Official Contact | 7193587338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Valley Health Care Llc 10265 Rolling Ridge Rd Colorado Springs CO 80925-9509 Ph: (719) 653-7776 | Fountain Valley Health Care Llc 5115 Fontaine Blvd Fountain CO 80817-1061 Ph: (719) 653-7776 |
| NPI Number | 1225890619 |
|---|---|
| Provider Enumeration Date | 01/30/2024 |
| Last Update Date | 06/26/2026 |
| Certification Date | 06/26/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225890619 | NPI | - | NPPES |
| 9000226000 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
Buck Jack, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6436 S Us Highway 85-87 Ste U, Fountain, CO 80817 Phone: 719-597-0822 Fax: 719-599-4606 | |
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Rocky Mountain Hope Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 709 Dale St Ste B, Fountain, CO 80817 Phone: 719-344-3864 | |
American Hospital Services Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Camino Del Rey, Fountain, CO 80817 Phone: 719-382-1370 | |
Amy Shandy, Speech-language Pathologist, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 N Santa Fe Ave, Fountain, CO 80817 Phone: 719-597-0822 Fax: 719-597-0822 | |
Peak Potential Behavior & Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8324 Cedar Chase Dr, Fountain, CO 80817 Phone: 719-331-1781 Fax: 719-638-8115 | |
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