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Organization
IDEAL COMMUNITY CARE,LLC
Active
Organization
IDEAL COMMUNITY CARE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NGOZI EDMUNDS (ADMINISTRATOR)
(662) 342-7023
Entity
Organization
Contact information
Practice address
8869 CENTRE STR #3, SOUTHAVEN, MS 38671
(662) 342-7023
(662) 342-7089
Mailing address
8869 CENTRE ST STE 3, SOUTHAVEN, MS 38671-1725
(662) 342-7023
(662) 342-7089
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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