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Organization
FELLOWSHIP ASSISTED LIVING LLC
Active
Organization
FELLOWSHIP ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA KIKONTWE RDH (MANAGER)
(314) 420-2928
Entity
Organization
Contact information
Practice address
2345 MONTICELLO CIR, PLANO, TX 75075-6678
(214) 407-1326
Mailing address
2345 MONTICELLO CIR, PLANO, TX 75075-6678
(214) 407-1326
Taxonomy
Speciality
Code
Description
License number
State
364SL0600X
Long-Term Care Clinical Nurse Specialist
Primary
—
NULL
364SL0600X
Long-Term Care Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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