Fortitude 611 Llc

LBN: Fortitude 611 Llc
Fortitude 611 Llc is an health care organization with primary practice located at 25062 S 190Th St , Queen Creek AZ 85142-5668. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness. Agencies / Community/Behavioral Health is the primary health care specialty. Fortitude 611 Llc can be contacted via phone (480) 329-0707, or through Ingram, Jaime via phone (480) 329-0707.

Contact Information

Primary practice address
25062 S 190Th St Queen Creek AZ 85142-5668
Phone: (480) 329-0707
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ingram, Jaime
Phone: (480) 329-0707

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X

Profile Details

NPI number 1003504390
LBN Legal business name Fortitude 611 Llc
DBA Doing business as
Authorized official Ingram, Jaime
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2023
Last updated Apr 26th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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