Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fortitude 611 LLC

Organization Community/Behavioral Health Agency · NPI 1003504390

Fortitude 611 LLC is a Community/Behavioral Health Agency in Queen Creek, Arizona. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

25062 S 190th St
Queen Creek, AZ 85142-5668
Phone: (480) 329-0707
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X
Mental Illness Community Based Residential Treatment Facility Taxonomy 320800000X

Record details

NPI number1003504390
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jaime Ingram — Owner · (480) 329-0707
NPI enumeratedApril 25, 2023
Last updated in NPPESApril 26, 2023
Certification dateApril 26, 2023
Mailing address25062 S 190th St, Queen Creek, AZ 85142-5668

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