Provider Demographics
NPI:1356679252
Name:IDEAL HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:IDEAL HOME CARE SERVICES, INC.
Other - Org Name:IDEAL HOME CARE SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LABORDE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:631-509-5600
Mailing Address - Street 1:3241 ROUT2 112 BUILDING 7
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-1424
Mailing Address - Country:US
Mailing Address - Phone:631-509-5600
Mailing Address - Fax:631-509-5599
Practice Address - Street 1:3241 ROUT2 112 BUILDING 7
Practice Address - Street 2:SUITE 5
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-1424
Practice Address - Country:US
Practice Address - Phone:631-509-5600
Practice Address - Fax:631-509-5599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1971L001251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care