Provider Demographics
NPI:1427671429
Name:FELLOWSHIP HEALTH RESOURCES, INC.
Entity type:Organization
Organization Name:FELLOWSHIP HEALTH RESOURCES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR 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
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-3746
Mailing Address - Country:US
Mailing Address - Phone:401-642-4416
Mailing Address - Fax:401-642-4453
Practice Address - Street 1:606 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-1211
Practice Address - Country:US
Practice Address - Phone:302-854-0626
Practice Address - Fax:302-752-1500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FELLOWSHIP HEALTH RESOURCES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
323P00000XOtherWASHINGTON PUBLISING CO