MEDICARE: FORTIS SUPPORT SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	385HR2055X	Child Mental Illness Respite Care
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	320800000X	Mental Illness Community Based Residential Treatment Facility
4	101YM0800X	Mental Health Counselor
5	1041C0700X	Clinical Social Worker
6	251C00000X	Developmentally Disabled Services Day Training Agency
7	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1164202966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORTIS SUPPORT SERVICES INC

Provider Business Mailing Address
First Line	:	246 E GARRISON BLVD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-0460
Country	:	US
Telephone Number	:	702-470-7752
Fax Number	:

Provider Business Practice Location Address
First Line	:	246 E GARRISON BLVD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-0460
Country	:	US
Telephone Number	:	980-336-1414
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ANDREW WATKINS
Credential	:
Telephone Number	:	770-568-7889

Provider Enumeration Date	:	09/29/2023
Last Update Date	:	02/10/2026

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Directions to “FORTIS SUPPORT SERVICES INC ” Practice Location

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