Provider Demographics
NPI:1831302371
Name:IDEAL CARE & HEALTH SERVICES INC
Entity Type:Organization
Organization Name:IDEAL CARE & HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:U
Authorized Official - Last Name:VINHELLENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-865-0191
Mailing Address - Street 1:4 VILLAGE LOOP RD STE B10
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-4891
Mailing Address - Country:US
Mailing Address - Phone:909-865-0191
Mailing Address - Fax:909-865-0193
Practice Address - Street 1:4 VILLAGE LOOP RD STE B10
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-4891
Practice Address - Country:US
Practice Address - Phone:909-865-0191
Practice Address - Fax:909-865-0193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190544AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA190544ANOtherAOD CERTIFICATION