Organization
I & A SUPPORTING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IBRAHIM KOROMA (OWNER)
(336) 908-1832
Entity
Organization
Contact information
Practice address
8433 SOUTHSIDE BLVD APT 406, JACKSONVILLE, FL 32256-8467
(336) 908-1832
Mailing address
8433 SOUTHSIDE BLVD APT 406, JACKSONVILLE, FL 32256-8467
(336) 908-1832
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
03/04/2022
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