Provider Demographics
NPI:1295452779
Name:IFKA COMMUNITY SERVICES
Entity type:Organization
Organization Name:IFKA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IFRAAX
Authorized Official - Middle Name:
Authorized Official - Last Name:SACIID-CIISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-344-4475
Mailing Address - Street 1:229 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7704
Mailing Address - Country:US
Mailing Address - Phone:207-344-4475
Mailing Address - Fax:
Practice Address - Street 1:229 LISBON ST STE B
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7704
Practice Address - Country:US
Practice Address - Phone:207-344-4475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health