Organization
FABOS COMMUNITY INTERSECTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EUNICE FUNKE AKINGBADE (MANAGING)
(817) 987-7634
Entity
Organization
Contact information
Practice address
924 MARION AVE, FORT WORTH, TX 76104-6537
(817) 987-7634
Mailing address
PO BOX 5133, ARLINGTON, TX 76005-5133
(817) 987-7634
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/17/2008
Last updated
01/17/2008
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