Fortitude 611 LLC
NPI 1003504390 · Community/Behavioral Health Agency · Queen Creek, AZ
Fortitude 611 LLC is a Community/Behavioral Health Agency organization in Queen Creek, AZ (NPI 1003504390).
Provider details
- NPI number
- 1003504390
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Jaime Ingram, Owner(480) 329-0707
Specialties & taxonomies
Agencies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-04-25
- Last updated
- 2023-04-26
- Certified
- 2023-04-26
Frequently asked questions
- What is Fortitude 611 LLC's NPI number?
- Fortitude 611 LLC's National Provider Identifier (NPI) is 1003504390, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fortitude 611 LLC?
- Fortitude 611 LLC is classified in the NPPES registry as Community/Behavioral Health Agency (Agencies).
- Where is Fortitude 611 LLC located?
- Fortitude 611 LLC's practice location on file with NPPES is 25062 S 190th St, Queen Creek, AZ 85142-5668.
- What is Fortitude 611 LLC's phone number?
- The practice phone number listed in the NPPES registry for Fortitude 611 LLC is (480) 329-0707.
- Who is the authorized official for Fortitude 611 LLC?
- The authorized official listed on Fortitude 611 LLC's NPPES record is Jaime Ingram, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fortitude 611 LLC's NPI active?
- Yes — Fortitude 611 LLC's NPI (1003504390) is active in the NPPES registry as of the last update on 2023-04-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.