OrganizationActive
Fountain Valley Health Care LLC
NPI 1043074024 · Psychiatric/Mental Health Nurse Practitioner · Colorado Springs, CO
Provider details
- NPI number
- 1043074024
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- Fountain Valley Health Care LLC
- Organization subpart
- Yes
- Authorized official
- Jacquita Jordan, Owner(719) 358-7338
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Counselor101Y00000X
Behavioral Health & Social Service Providers
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1520 Verde Dr
Colorado Springs, CO 80910-1931
Phone: (719) 653-7776
Approximate (ZIP-level) locationGet directions
Mailing address
1259 Lake Plaza Dr Ste 270
Colorado Springs, CO 80906-3560
Other names (DBA / former)
- Doing business as
- Family Success Center Behavioral Health
Registry dates
- Enumerated
- 2024-02-09
- Last updated
- 2024-02-09
- Certified
- 2024-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.