Provider Demographics
NPI:1205145893
Name:LORSAM RESIDENTIAL HOMES INC
Entity type:Organization
Organization Name:LORSAM RESIDENTIAL HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TANGYI
Authorized Official - Middle Name:FOCHO
Authorized Official - Last Name:FOGWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-207-9255
Mailing Address - Street 1:8108 MODESTO DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-8545
Mailing Address - Country:US
Mailing Address - Phone:913-207-9255
Mailing Address - Fax:
Practice Address - Street 1:8108 MODESTO DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-8545
Practice Address - Country:US
Practice Address - Phone:913-207-9255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness