Organization
IDEAL SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE LONG (ADMINISTRATOR)
(443) 442-6043
Entity
Organization
Contact information
Practice address
6031 KANSAS AVE NW, NW SUITE 201, WASHINGTON, DC 20011-1566
(410) 258-9310
(410) 665-7558
Mailing address
6031 KANSAS AVE NW, NW SUITE 201, WASHINGTON, DC 20011-1566
(410) 258-9310
(410) 665-7558
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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