Fortitude Recovery LLC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

License

0002934671-0001-4 Issued in CA

Legal business name

FORTITUDE RECOVERY LLC

Practice address

2477 Fletcher Dr
Los Angeles, CA 90039-2801

Phone

(323) 375-5959

Fax

(323) 419-3165

NPI assigned

Oct 13, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rod Amiri, M.D.

Title

Executive Director

Phone

(323) 375-5959

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1013467091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2477 FLETCHER DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392801",
            "telephone_number": "323-375-5959",
            "fax_number": "323-419-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2477 FLETCHER DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392801",
            "telephone_number": "323-375-5959",
            "fax_number": "323-419-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTITUDE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "AMIRI",
        "authorized_official_first_name": "ROD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "323-375-5959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "CA",
            "license": "0002934671-0001-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.