Provider Demographics
NPI:1164531901
Name:IDEAL HOME CARE, LLC.
Entity Type:Organization
Organization Name:IDEAL HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:BARONGO
Authorized Official - Last Name:ONGERI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:952-220-6198
Mailing Address - Street 1:750 2ND ST NE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8587
Mailing Address - Country:US
Mailing Address - Phone:952-392-2314
Mailing Address - Fax:952-392-2315
Practice Address - Street 1:1050 HIAWATHA AVE
Practice Address - Street 2:# 339
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-8144
Practice Address - Country:US
Practice Address - Phone:952-220-6198
Practice Address - Fax:952-935-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN333665251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health