Provider Demographics
NPI:1700664539
Name:IGNITE CONSULTS
Entity Type:Organization
Organization Name:IGNITE CONSULTS
Other - Org Name:IGNITE CONSULTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-542-6086
Mailing Address - Street 1:3312 CORD PL
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2551
Mailing Address - Country:US
Mailing Address - Phone:404-542-6086
Mailing Address - Fax:
Practice Address - Street 1:3312 CORD PLACE
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227
Practice Address - Country:US
Practice Address - Phone:202-621-4489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No342000000XTransportation ServicesTransportation Network Company
No347C00000XTransportation ServicesPrivate Vehicle