Organization
LORSAM RESIDENTIAL HOMES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANGYI FOCHO FOGWE (PRESIDENT)
(913) 207-9255
Entity
Organization
Contact information
Practice address
8108 MODESTO DR, ARLINGTON, TX 76001-8545
(913) 207-9255
Mailing address
8108 MODESTO DR, ARLINGTON, TX 76001-8545
(913) 207-9255
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
09/29/2010
Last updated
10/02/2010
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