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General NPI Number Information
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NPI Number | 1356646103
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Entity Type | Organization
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Legal Business Name | FELLOWSHIP HEALTH RESOURCES, INC.
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 24 ALBION RD STE 420
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City | LINCOLN
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State | RI
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Zip | 02865-3744
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Country | US
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Telephone | 401-333-3980
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Fax | 401-333-3984
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Provider Business Mailing Address
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Address Line | 24 ALBION RD STE 420
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City | LINCOLN
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State | RI
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Zip | 02865-3744
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Country | US
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Telephone | 401-333-3980
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Fax | 401-333-3984
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Authorized Official
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Title or Position | DIR. OF CONTRACTS AND CREDENTIALING
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Name | DONNA BUSCH
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Credential |
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Telephone | 445-206-3028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 134980
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 134980
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License Number State | PA
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