Provider Demographics
NPI:1619282100
Name:IDEAL RESPONSE SERVICES LLC
Entity Type:Organization
Organization Name:IDEAL RESPONSE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LITRESH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-430-6024
Mailing Address - Street 1:1775 GRAHAM AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5948
Mailing Address - Country:US
Mailing Address - Phone:252-430-6024
Mailing Address - Fax:
Practice Address - Street 1:1775 GRAHAM AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5948
Practice Address - Country:US
Practice Address - Phone:252-430-6024
Practice Address - Fax:252-430-6023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health