Provider Demographics
NPI:1538723853
Name:FAMILY FELLOWSHIP SERVICES LLC
Entity type:Organization
Organization Name:FAMILY FELLOWSHIP SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHINDELMEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-427-4451
Mailing Address - Street 1:362 LEGACY DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-5503
Mailing Address - Country:US
Mailing Address - Phone:702-427-4451
Mailing Address - Fax:
Practice Address - Street 1:362 LEGACY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-5503
Practice Address - Country:US
Practice Address - Phone:702-427-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20190175362-76Medicaid
NVNV20191309115OtherBUSINESS LICENSE