Provider Demographics
NPI:1477310381
Name:FELLOWSHIP HEALTH RESOURCES, INC
Entity Type:Organization
Organization Name:FELLOWSHIP HEALTH RESOURCES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-642-4410
Mailing Address - Street 1:24 ALBION RD STE 420
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-3744
Mailing Address - Country:US
Mailing Address - Phone:401-642-4410
Mailing Address - Fax:
Practice Address - Street 1:12 S SPRINGVIEW DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-5550
Practice Address - Country:US
Practice Address - Phone:302-390-5372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness