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General NPI Number Information
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NPI Number | 1396832820
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Entity Type | Organization
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Legal Business Name | VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 310C COUNTY ROAD 14
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City | DEL NORTE
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State | CO
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Zip | 81132-8719
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Country | US
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Telephone | 719-657-2418
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Fax | 719-657-3317
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Provider Business Mailing Address
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Address Line | 310 COUNTY ROAD 14
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City | DEL NORTE
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State | CO
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Zip | 81132-8719
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Country | US
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Telephone | 719-657-2510
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Fax | 719-657-4106
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Authorized Official
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Title or Position | ADMINISTRATION SEC/CREDENTIALING
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Name | JENNY M GALLEGOS
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Credential |
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Telephone | 719-850-4948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 06-8504
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License Number State | CO
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