Provider Demographics
NPI:1336616820
Name:IDEAL HOME COMPANION SERVICES, LLC
Entity Type:Organization
Organization Name:IDEAL HOME COMPANION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PACAUD BREZAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-566-5061
Mailing Address - Street 1:224 DATURA ST STE 211
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5630
Mailing Address - Country:US
Mailing Address - Phone:561-566-5061
Mailing Address - Fax:
Practice Address - Street 1:224 DATURA ST STE 211
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5630
Practice Address - Country:US
Practice Address - Phone:561-566-5061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health