Provider Demographics
NPI:1063036770
Name:IDEAL MENTAL HEALTH AND WELLNESS CARE, LLC.
Entity Type:Organization
Organization Name:IDEAL MENTAL HEALTH AND WELLNESS CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVIECA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, PMHNP-BC
Authorized Official - Phone:321-231-9120
Mailing Address - Street 1:600 STEWART ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1217
Mailing Address - Country:US
Mailing Address - Phone:206-331-3111
Mailing Address - Fax:206-331-3189
Practice Address - Street 1:600 STEWART ST STE 400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1217
Practice Address - Country:US
Practice Address - Phone:206-331-3111
Practice Address - Fax:206-331-3189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)