1821261488 NPI number — VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC

Table of content: (NPI 1821261488)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821261488 NPI number — VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RIO GRANDE HOSPITAL CLINICS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821261488
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
0310 COUNTY ROAD 14
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEL NORTE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81132-8719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-657-2510
Provider Business Mailing Address Fax Number:
719-657-2511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310C COUNTY ROAD 14
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEL NORTE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81132-8719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-657-2510
Provider Business Practice Location Address Fax Number:
719-657-2511
Provider Enumeration Date:
04/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HARMS
Authorized Official First Name:
ARLENE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
719-657-4104

Provider Taxonomy Codes

  • Taxonomy code: 261QE0002X , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 90871022 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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