Provider Demographics
NPI:1053136267
Name:ISSAA RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:ISSAA RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:ABLOYOU
Authorized Official - Last Name:MARZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-507-7292
Mailing Address - Street 1:345 SUNNYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:DE
Mailing Address - Zip Code:19734-9043
Mailing Address - Country:US
Mailing Address - Phone:302-507-7292
Mailing Address - Fax:
Practice Address - Street 1:345 SUNNYSIDE LN
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:DE
Practice Address - Zip Code:19734-9043
Practice Address - Country:US
Practice Address - Phone:302-507-7292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care