Provider Demographics
NPI:1386191302
Name:FELLOWSHIP VILLAGE INC.
Entity type:Organization
Organization Name:FELLOWSHIP VILLAGE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-580-3805
Mailing Address - Street 1:8000 FELLOWSHIP RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3915
Mailing Address - Country:US
Mailing Address - Phone:908-580-9519
Mailing Address - Fax:908-580-5186
Practice Address - Street 1:8000 FELLOWSHIP RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-3915
Practice Address - Country:US
Practice Address - Phone:908-580-9519
Practice Address - Fax:908-580-5186
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FELLOWSHIP VILLAGE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-07
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based