Provider Demographics
NPI:1720181225
Name:VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
Entity Type:Organization
Organization Name:VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC
Other - Org Name:RIO GRANDE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-657-2510
Mailing Address - Street 1:310 COUNTY ROAD 14
Mailing Address - Street 2:
Mailing Address - City:DEL NORTE
Mailing Address - State:CO
Mailing Address - Zip Code:81132-8719
Mailing Address - Country:US
Mailing Address - Phone:719-657-2510
Mailing Address - Fax:719-657-4106
Practice Address - Street 1:310 COUNTY ROAD 14
Practice Address - Street 2:
Practice Address - City:DEL NORTE
Practice Address - State:CO
Practice Address - Zip Code:81132-8719
Practice Address - Country:US
Practice Address - Phone:719-657-2510
Practice Address - Fax:719-657-4106
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY CITIZENS' FOUNDATION FOR HEALTH CARE INC DBA RIO GRANDE HOSPITA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-07
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06Z301275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05000203Medicaid
CO05000203Medicaid
COCL7708Medicare PIN