Provider Demographics
NPI:1003934795
Name:IDEAL HOME CARE OF GA
Entity Type:Organization
Organization Name:IDEAL HOME CARE OF GA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:228-831-1510
Mailing Address - Street 1:182 RILEY AVE STE F2
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-0778
Mailing Address - Country:US
Mailing Address - Phone:478-757-1002
Mailing Address - Fax:
Practice Address - Street 1:182 RILEY AVE STE F2
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-0778
Practice Address - Country:US
Practice Address - Phone:478-757-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055R0004251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based