Provider Demographics
NPI:1528730439
Name:IDEAL HEALTHCARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:IDEAL HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LATIA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:O'BANNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-718-9579
Mailing Address - Street 1:1055 INGLESIDE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1337
Mailing Address - Country:US
Mailing Address - Phone:443-718-9579
Mailing Address - Fax:410-998-9579
Practice Address - Street 1:1055 INGLESIDE AVE STE 100
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1337
Practice Address - Country:US
Practice Address - Phone:443-718-9579
Practice Address - Fax:410-998-9579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care