Provider Demographics
NPI:1205408986
Name:IGULU SOCIAL ASSISTANCE SERVICES LLC
Entity type:Organization
Organization Name:IGULU SOCIAL ASSISTANCE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TWAFIKA
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:IGULU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-404-3385
Mailing Address - Street 1:6858 S SALT CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-5120
Mailing Address - Country:US
Mailing Address - Phone:520-404-3385
Mailing Address - Fax:
Practice Address - Street 1:2935 S KOLB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1747
Practice Address - Country:US
Practice Address - Phone:520-404-3385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child