Organization
FARMINGTON PLACE HEALTHCARE SERVICES
Active
Other names
Farmington Place Habilitation Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEHINDE OLUGBOLAHAN OGUNDIPE (CEO/ADMINISTRATOR)
(214) 221-0020
Entity
Organization
Contact information
Practice address
11325 PEGASUS ST # S-142, DALLAS, TX 75238-5239
(214) 221-0020
Mailing address
11325 PEGASUS ST S-142, DALLAS, TX 75238-5239
(214) 221-0020
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
9059
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9059
TEXAS HCSSA LICENSE #
TX
Enumeration date
09/08/2008
Last updated
09/08/2008
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