Provider Demographics
NPI:1710078811
Name:IDEAL HOME CARE SERVICE, INC.
Entity Type:Organization
Organization Name:IDEAL HOME CARE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RACHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-353-2230
Mailing Address - Street 1:8 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4015
Mailing Address - Country:US
Mailing Address - Phone:401-353-2230
Mailing Address - Fax:401-353-5148
Practice Address - Street 1:8 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4015
Practice Address - Country:US
Practice Address - Phone:401-353-2230
Practice Address - Fax:401-353-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHCP02413251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIIH03390OtherPROVIDER NUMBER