Provider Demographics
NPI:1245980309
Name:24/7 IDEAL HOMECARE AGENCY LLC
Entity type:Organization
Organization Name:24/7 IDEAL HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:GEOHAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-570-1098
Mailing Address - Street 1:1230 AMELIA ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-5478
Mailing Address - Country:US
Mailing Address - Phone:803-570-1098
Mailing Address - Fax:
Practice Address - Street 1:1230 AMELIA ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-5478
Practice Address - Country:US
Practice Address - Phone:803-570-1098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care