FELLOWSHIP HALL, INC. (NPI# 1396934261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396934261 |
| Entity Type | Organization |
| Organization Name | FELLOWSHIP HALL, INC. |
| Practice Address |
5140 Dunstan Rd Greensboro NC 27405-9565 |
| Practice Telephone | 3366213381 |
| Practice Fax Number | 3366217513 |
| Mailing Telephone | 3366213381 |
| Mailing Fax Number | 3366217513 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2013-09-09 |
| Authorized Official Name | MR. BRAD MARINO (PRESIDENT AND CEO) |
| Authorized Official Telephone | 3366213381 |
| Is Organization Subpart | Y |
| Parent Organization Name | FELLOWSHIP HALL, INC. |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | MHH001 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225007719 | Fellowship Hall, Inc. | Substance Abuse Rehabilitation Facility | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2006-03-16 |
| 1942499819 | Fellowship Hall, Inc. | Substance Abuse Rehabilitation Facility | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2007-10-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | FELLOWSHIP HALL, INC. | 212 Babbitt Road, Bedford Hills, Ny 10507 |
| Street Address |
5140 DUNSTAN RD |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27405-9565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225007719 | Fellowship Hall, Inc. | Substance Abuse Rehabilitation Facility | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2006-03-16 |
| 1205436284 | Cyrus Kolar | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2020-10-28 |
| 1649627795 | Latimer Breck Alexander V | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2016-05-18 |
| 1952775017 | Crystal Vechlekar Blair | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2015-11-30 |
| 1477946960 | Michael Yow | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2015-03-09 |
| 1679965388 | Terri Spears | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2015-03-04 |
| 1609287408 | Mahala Motzny | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2014-05-14 |
| 1194155887 | Marvin Mathias Sandifer | Social Worker | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2013-11-18 |
| 1457780439 | Kelly Shelton Scaggs | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2013-11-11 |
| 1881822286 | Terry A Whitling | Counselor | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2009-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477038727 | Miya Jackson | Behavior Technician | 2308 Golden Gate Dr, Apt G, Greensboro, NC 27405 | 2018-10-02 |
| 1821576299 | Woodrow Eric Bradley | Day Training/Habilitation Specialist | 1403 Woocbriar Ave, Greensboro, NC 27405 | 2018-07-30 |
| 1922593094 | Constance Foushee | Nurse Practitioner | 1100 E. Wendover, Greensboro, NC 27405 | 2018-06-29 |
| 1760972434 | Ayana Linette Holland | Home Health Aide | 1417 Old Hickory Dr, Greensboro, NC 27405 | 2018-05-17 |
| 1790294700 | G. Antoine Gray | Specialist | 2100 Phillips Avenue, Suite B, Greensboro, NC 27405 | 2017-09-21 |
| 1306375910 | Wendy Carisa Boger | Registered Nurse | 1100 East Wendover Avenue, Greensboro, NC 27405 | 2017-06-07 |
| 1659827715 | Changing Paths Counseling Center Pllc | Community/Behavioral Health | 1600 E Wendoer Ave., Suite C, Greensboro, NC 27405 | 2016-08-29 |
| 1295187896 | Amanda Kirby Counseling, PC | Counselor | 1175 Revolution Mill Drive, Suite 29-2, Greensboro, NC 27405 | 2016-07-07 |
| 1780049429 | Pta | Residential Treatment Facility, Physical Disabilities | 1900 Sheldon Road, Greensboro, NC 27405 | 2015-12-23 |
| 1841655644 | Amaya Nicole Hardy | Counselor | 1600r E Wendover Ave Ste R, Greensboro, NC 27405 | 2015-12-21 |
| Find all providers in zip 27405 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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|---|---|---|---|---|
| 1235785726 | Eighth Month Ventures, LLC | Substance Abuse Rehabilitation Facility | 405 Franklin Blvd, Greensboro, NC 27401-4610 | 2019-08-12 |
| 1811442312 | Serenity Grove, L.L.C. | Substance Abuse Rehabilitation Facility | 1021 Parkside Cmns, Suite 104, Greensboro, GA 30642-4521 | 2016-08-25 |
| 1710200415 | Life Structures, Inc. | Substance Abuse Rehabilitation Facility | 1822 Sharpe Rd, Greensboro, NC 27406-9413 | 2010-03-09 |
| 1790918068 | The Malachi House, Inc. | Substance Abuse Rehabilitation Facility | 507 Balboa St, Greensboro, NC 27405-6405 | 2009-09-02 |
| 1568674141 | D.r.e.a.m.s. Treatment Services, Inc. | Substance Abuse Rehabilitation Facility | 620 Martin St, Greensboro, NC 27406-1741 | 2007-05-04 |
| 1225007719 | Fellowship Hall, Inc. | Substance Abuse Rehabilitation Facility | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2006-03-16 |
| 1861714511 | Stroud House | Substance Abuse Rehabilitation Facility | 200 E Mcculloch St, Greensboro, NC 27406-1439 | 2010-02-23 |
| 1942499819 | Fellowship Hall, Inc. | Substance Abuse Rehabilitation Facility | 5140 Dunstan Rd, Greensboro, NC 27405-9565 | 2007-10-17 |
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|---|---|---|---|---|
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| 1982212874 | Hall Empowerment Network | Substance Abuse Rehabilitation Facility | 4450 Kinkead Ct Apt 33, Fayetteville, NC 28314-2420 | 2020-07-16 |
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| 1609408269 | Pear Tree Peace Community Economic Development Corporation | Substance Abuse Rehabilitation Facility | 612 Pine Tops Rd, Murfreesboro, NC 27855-9595 | 2020-02-11 |
| 1396383352 | Deerhaven Gardens, LLC. | Substance Abuse Rehabilitation Facility | 66 N Deerhaven Ln, Asheville, NC 28803-0120 | 2019-12-20 |
| 1255973210 | Blissfully Supported LLC | Substance Abuse Rehabilitation Facility | 645 Dunbrook Ln, Charlotte, NC 28217-3405 | 2019-10-11 |
| 1538720396 | Adaptive Interventions Group, LLC | Substance Abuse Rehabilitation Facility | 107 Robinson Dr, Cherryville, NC 28021-8100 | 2019-06-24 |
| 1356813802 | Red Oak Adolescent Recovery LLC | Substance Abuse Rehabilitation Facility | 517 Cub Creek Rd, Ellenboro, NC 28040-8733 | 2018-12-21 |
| 1619475308 | Titan Holding Group, LLC | Substance Abuse Rehabilitation Facility | 4944 Parkway Plaza Ste 200, Charlotte, NC 28217-0000 | 2018-01-27 |
| 1144737016 | Sea Coast Recovery, LLC | Substance Abuse Rehabilitation Facility | 880 Martin Luther King Jr Blvd, Chapel Hill, NC 27514-2600 | 2018-01-02 |
| Find all providers with the same taxonomy | ||||
| City | GREENSBORO |
| Zip Code | 27405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.