Provider Demographics
NPI:1215515341
Name:FELLO INC
Entity type:Organization
Organization Name:FELLO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-269-1883
Mailing Address - Street 1:999 CORPORATE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2271
Mailing Address - Country:US
Mailing Address - Phone:410-269-1883
Mailing Address - Fax:410-384-4015
Practice Address - Street 1:1332 DONALD AVE
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-2630
Practice Address - Country:US
Practice Address - Phone:410-269-1883
Practice Address - Fax:410-384-4015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD156442100Medicaid
MD889034000Medicaid