Organization
FORTITUDE 611 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME INGRAM (OWNER)
(480) 329-0707
Entity
Organization
Contact information
Practice address
25062 S 190TH ST, QUEEN CREEK, AZ 85142-5668
(480) 329-0707
Mailing address
25062 S 190TH ST, QUEEN CREEK, AZ 85142-5668
(480) 329-0707
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
04/25/2023
Last updated
04/26/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us