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General NPI Number Information
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NPI Number | 1164202966
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Entity Type | Organization
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Legal Business Name | FORTIS SUPPORT SERVICES INC
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Dates
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Enumeration Date | 09/29/2023
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 246 E GARRISON BLVD
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City | GASTONIA
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State | NC
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Zip | 28054-0460
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Country | US
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Telephone | 980-336-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 246 E GARRISON BLVD
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City | GASTONIA
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State | NC
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Zip | 28054-0460
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Country | US
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Telephone | 702-470-7752
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ANDREW WATKINS
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Credential |
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Telephone | 770-568-7889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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