| Fortitude Mental Health Services L.l.c | |
|
101 Central Ave Sw Le Mars IA 51031-3620 | |
| (712) 522-1119 | |
| (712) 587-9695 |
| Full Name | Fortitude Mental Health Services L.l.c |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 101 Central Ave Sw, Le Mars, Iowa |
| Authorized Official Name and Position | Jennifer Lynn Ruden (OWNER) |
| Authorized Official Contact | 7125221119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortitude Mental Health Services L.l.c 101 Central Ave Sw Le Mars IA 51031-3620 Ph: (712) 522-1119 | Fortitude Mental Health Services L.l.c 101 Central Ave Sw Le Mars IA 51031-3620 Ph: (712) 522-1119 |
| NPI Number | 1982054524 |
|---|---|
| Provider Enumeration Date | 06/14/2016 |
| Last Update Date | 08/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982054524 | NPI | - | NPPES |
| 13575944 | Other | IA | CAQH |
| 600849393 | Medicaid | IA | |
| 1689924466 | Other | IA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 001719 (Iowa) | Secondary |
| 251S00000X | Community/behavioral Health | 001719 (Iowa) | Primary |
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