Provider Demographics
NPI:1417385444
Name:IBHS LLC
Entity Type:Organization
Organization Name:IBHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZERUBABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YISHRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:240-491-2423
Mailing Address - Street 1:5000 BARNABAS ROAD
Mailing Address - Street 2:CT2
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748
Mailing Address - Country:US
Mailing Address - Phone:772-219-4041
Mailing Address - Fax:772-872-5287
Practice Address - Street 1:5000 BARNABAS ROAD
Practice Address - Street 2:CT2
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748
Practice Address - Country:US
Practice Address - Phone:772-219-4041
Practice Address - Fax:772-872-5287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility