| NPI | 1245697226 |
|---|---|
| Former Legal Business Name | FAR EAST FOSTER HOME |
| Entity Type | Organization |
| Authorized Contact | MOBOLAJI JOHNSON OMOTOSHO CEO 915-861-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: TX HFFX15-00079) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |