Provider Demographics
NPI:1699508069
Name:IDEAL HOME HEALTH LLC
Entity type:Organization
Organization Name:IDEAL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:
Authorized Official - Last Name:IGWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-435-5296
Mailing Address - Street 1:3121 YEW GROVE PL
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2742
Mailing Address - Country:US
Mailing Address - Phone:571-277-7111
Mailing Address - Fax:
Practice Address - Street 1:3121 YEW GROVE PL
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2742
Practice Address - Country:US
Practice Address - Phone:571-277-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health