# IDEAL HOME CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669689048
- **Authorized official:** EUGENE HARDIN M.D. (LICENSEE)
- **Authorized official phone:** (310) 739-3585

## Contact information

- **Practice address:** 4830 W 130TH ST, HAWTHORNE, CA 90250-5010
- **Practice address phone:** (310) 973-8266
- **Practice address fax:** (310) 675-8760
- **Mailing address:** 4000 W 139TH ST, HAWTHORNE, CA 90250-7304
- **Mailing address phone:** (310) 739-3585
- **Mailing address fax:** (310) 377-9508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | — | CA | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 08/22/2020