Provider Demographics
NPI:1043961501
Name:FORTRESS HOME CARE NY
Entity type:Organization
Organization Name:FORTRESS HOME CARE NY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-430-9600
Mailing Address - Street 1:123 WOODCROFT DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-1420
Mailing Address - Country:US
Mailing Address - Phone:585-430-9600
Mailing Address - Fax:
Practice Address - Street 1:123 WOODCROFT DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-1420
Practice Address - Country:US
Practice Address - Phone:585-430-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health