Provider Demographics
NPI:1205204559
Name:IDEAL HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:IDEAL HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADHAV
Authorized Official - Middle Name:
Authorized Official - Last Name:DHITAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-277-6301
Mailing Address - Street 1:3012 SNOW RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-2954
Mailing Address - Country:US
Mailing Address - Phone:216-482-5541
Mailing Address - Fax:
Practice Address - Street 1:3012 SNOW RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-2954
Practice Address - Country:US
Practice Address - Phone:216-482-5541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IDEAL HOMECARE AGENCY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-03
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care