Provider Demographics
NPI:1760631329
Name:IDEAL HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:IDEAL HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIPA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-449-0916
Mailing Address - Street 1:6751 DIXIE HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2080
Mailing Address - Country:US
Mailing Address - Phone:586-323-7110
Mailing Address - Fax:586-323-7133
Practice Address - Street 1:6751 DIXIE HWY STE 202
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2080
Practice Address - Country:US
Practice Address - Phone:586-323-7110
Practice Address - Fax:586-323-7133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health