Provider Demographics
NPI:1588543730
Name:FORTUITY HOME HEALTH & SENIOR CARE
Entity type:Organization
Organization Name:FORTUITY HOME HEALTH & SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:BSN-RN
Authorized Official - Phone:980-236-8655
Mailing Address - Street 1:1123 WELL SPRING DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3265
Mailing Address - Country:US
Mailing Address - Phone:336-858-4286
Mailing Address - Fax:
Practice Address - Street 1:1123 WELL SPRING DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3265
Practice Address - Country:US
Practice Address - Phone:336-858-4286
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care