Provider Demographics
NPI:1134017676
Name:MOSFA
Entity type:Organization
Organization Name:MOSFA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANANGER
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESEREM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-612-2118
Mailing Address - Street 1:2024 N WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-1213
Mailing Address - Country:US
Mailing Address - Phone:360-612-2118
Mailing Address - Fax:
Practice Address - Street 1:2024 N WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-1213
Practice Address - Country:US
Practice Address - Phone:360-612-2118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty