Provider Demographics
NPI:1003228214
Name:FJV FOUNDATION
Entity Type:Organization
Organization Name:FJV FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-786-3475
Mailing Address - Street 1:1601 OSPREY DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-8818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 OSPREY DR
Practice Address - Street 2:SUITE 206
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-8818
Practice Address - Country:US
Practice Address - Phone:972-786-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals