Healthcare Provider Details

I. General information

NPI: 1255444501
Provider Name (Legal Business Name): FORTRESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 STRICKLAND DR
WOODSTOCK AL
35188-3450
US

IV. Provider business mailing address

65 STRICKLAND DR
WOODSTOCK AL
35188-3450
US

V. Phone/Fax

Practice location:
  • Phone: 205-938-1218
  • Fax: 205-938-1130
Mailing address:
  • Phone: 205-938-1218
  • Fax: 205-938-1130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. REGINALD SCOTT NICHOLS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 205-938-1218