Provider Demographics
NPI:1427215706
Name:FRIENDS FELLOWSHIP COMMUNITY, INC.
Entity Type:Organization
Organization Name:FRIENDS FELLOWSHIP COMMUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE & DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-962-6546
Mailing Address - Street 1:2030 CHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1215
Mailing Address - Country:US
Mailing Address - Phone:765-962-6546
Mailing Address - Fax:765-962-9188
Practice Address - Street 1:2030 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1215
Practice Address - Country:US
Practice Address - Phone:765-962-6546
Practice Address - Fax:765-962-9188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07-001128-1310400000X, 311500000X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)