Provider Demographics
NPI:1043720436
Name:IDEAL IN HOMECARE,LLC
Entity Type:Organization
Organization Name:IDEAL IN HOMECARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-222-3368
Mailing Address - Street 1:77 UNION ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2934
Mailing Address - Country:US
Mailing Address - Phone:508-222-3368
Mailing Address - Fax:
Practice Address - Street 1:77 UNION ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2934
Practice Address - Country:US
Practice Address - Phone:508-222-3368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care