Fortress Behavioral Services Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FORTRESS BEHAVIORAL SERVICES INC

Practice address

836 Churchill Dr
Shelby, NC 28150-6006

Phone

(704) 472-6183

NPI assigned

May 17, 2012

Last updated

May 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gary Gullatte Jr.

Title

Owner/Executive Director

Phone

(704) 472-6183

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1962762542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 CHURCHILL DR",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281506006",
            "telephone_number": "704-472-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 CHURCHILL DR",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281506006",
            "telephone_number": "704-472-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTRESS BEHAVIORAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "GULLATTE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-472-6183",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.