Provider Demographics
NPI:1619795408
Name:AYUBU FAMILY SERVICES LLC
Entity type:Organization
Organization Name:AYUBU FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEGMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGOMIRAKIZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-415-2080
Mailing Address - Street 1:184 CHUTE RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-4121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:184 CHUTE RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4121
Practice Address - Country:US
Practice Address - Phone:207-415-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care