Provider Demographics
NPI:1598237745
Name:FORTITUDE CARE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:FORTITUDE CARE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-200-8502
Mailing Address - Street 1:1415 CARDINAL HL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-3557
Mailing Address - Country:US
Mailing Address - Phone:210-200-8502
Mailing Address - Fax:210-200-5161
Practice Address - Street 1:1415 CARDINAL HL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-3557
Practice Address - Country:US
Practice Address - Phone:210-200-8502
Practice Address - Fax:210-200-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health