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General NPI Number Information
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NPI Number | 1619944089
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Entity Type | Organization
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Legal Business Name | IDEAL HOME CARE, INC.
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 720 E ARROW HWY
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City | COVINA
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State | CA
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Zip | 91722-2103
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Country | US
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Telephone | 626-966-7677
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Fax | 626-966-5260
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Provider Business Mailing Address
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Address Line | 720 E ARROW HWY
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City | COVINA
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State | CA
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Zip | 91722-2103
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Country | US
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Telephone | 626-966-7677
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Fax | 626-966-5260
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. NENITA A VITUG
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Credential | LVN
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Telephone | 626-966-7677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | CA
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