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General NPI Number Information
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NPI Number | 1891235305
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Entity Type | Organization
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Legal Business Name | FORTRESS HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 425 JOLIET ST STE. 321-B
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City | DYER
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State | IN
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Zip | 46311-1765
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Country | US
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Telephone | 219-515-2583
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Fax | 219-515-2839
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Provider Business Mailing Address
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Address Line | 425 JOLIET ST STE. 321-B
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City | DYER
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State | IN
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Zip | 46311-1765
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Country | US
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Telephone | 219-515-2583
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Fax | 219-515-2839
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Authorized Official
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Title or Position | AGENCY MANAGER
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Name | MRS. NDIDI OBIALOR
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Credential | RN
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Telephone | 219-515-2583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 17-017087-1
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License Number State | IN
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