NPIMap

Organization Active NPI

Fortitude Intensive Outpatient Program LLC

  • Adult Mental Health Clinic/Center
  • Branson, MO
National Provider Identifier
1902262991
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
FORTITUDE INTENSIVE OUTPATIENT PROGRAM LLC
Practice address
500 W Main St
St. 204
Branson, MO 65616-2727
Phone
(417) 243-7777
Fax
(417) 243-7778
NPI assigned
Jan 7, 2016
Last updated
Jan 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Authorized official

Name
Mrs. Shabana Insaf, PHD
Title
Manager
Phone
(417) 243-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

500 W Main St
St. 204
Branson, MO 65616-2727

Mailing address

500 W Main St
St. 204
Branson, MO 65616-2727
Phone (417) 243-7777

National Provider Directory

National Provider Directory

Locations

500 W Main St
Ste 204
Branson, MO 65616
Phone (417) 243-7777

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1902262991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "ST. 204",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162727",
            "telephone_number": "417-243-7777",
            "fax_number": "417-243-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "ST. 204",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162727",
            "telephone_number": "417-243-7777",
            "fax_number": "417-243-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTITUDE INTENSIVE OUTPATIENT PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "INSAF",
        "authorized_official_first_name": "SHABANA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "417-243-7777",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.