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General NPI Number Information
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NPI Number | 1477310381
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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 | 03/06/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 12 S SPRINGVIEW DR
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City | DOVER
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State | DE
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Zip | 19901-5550
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Country | US
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Telephone | 302-390-5372
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Fax |
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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 | 401-642-4410
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CONTRACTS AND CREDENTIA
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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