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Fortitude 611 LLC

Community/Behavioral Health Agency in Queen Creek, AZ · enumerated 2023 · authorized official Jaime Ingram, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1003504390

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Registry record

Entity type Organization (Type 2)
Legal business name Fortitude 611 LLC
Practice address 25062 S 190th St, Queen Creek, AZ, 85142
Phone (480) 329-0707
Enumeration date Apr 25, 2023
Last updated in NPPES Apr 26, 2023

Taxonomy & classification

251S00000X Community/Behavioral Health Agency Agencies Primary
320800000X Mental Illness Community Based Residential Treatment Facility Residential Treatment Facilities Secondary

Authorized official

Name Jaime Ingram
Title Owner
Phone (480) 329-0707

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Fortitude 611 LLC?
The NPI for Fortitude 611 LLC is 1003504390, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Fortitude 611 LLC?
NPPES lists Jaime Ingram (Owner) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-04-26.