Provider Demographics
NPI:1164822888
Name:FORTRESS CONSULTING AND EDUCATION LLC
Entity Type:Organization
Organization Name:FORTRESS CONSULTING AND EDUCATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MRG
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:855-275-5913
Mailing Address - Street 1:403 COOPER AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-3326
Mailing Address - Country:US
Mailing Address - Phone:855-275-5913
Mailing Address - Fax:318-918-1410
Practice Address - Street 1:403 COOPER AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-3326
Practice Address - Country:US
Practice Address - Phone:855-275-5913
Practice Address - Fax:318-918-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care