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Organization

IDEAL HEALTHCARE SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMMY YLONDA LEWIS RN (CEO)
(919) 755-0019
Entity
Organization

Contact information

Practice address
4900 WATERS EDGE DR, SUITE 205, RALEIGH, NC 27606-2484
(919) 755-0019
(919) 755-0021
Mailing address
4900 WATERS EDGE DR, SUITE 205, RALEIGH, NC 27606-2463
(919) 755-0019
(919) 755-0021

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6602253
NC
Enumeration date
03/31/2011
Last updated
05/21/2012
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