Organization
FELLOWSHIP HOUSE
Active
Organization
FELLOWSHIP HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICKEY RAE FINCH M.S. (CHIEF EXECUTIVE OFFICER)
(618) 833-4456
Entity
Organization
Contact information
Practice address
800 N MAIN ST, ANNA, IL 62906-1665
(618) 833-4456
(618) 833-2371
Mailing address
800 N MAIN ST, P.O. BOX 682, ANNA, IL 62906-1665
(618) 833-4456
(618) 833-2371
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
A-0626-0002-A
IL
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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