Organization
IDEAL HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE HARDIN M.D. (LICENSEE)
(310) 739-3585
Entity
Organization
Contact information
Practice address
4830 W 130TH ST, HAWTHORNE, CA 90250-5010
(310) 973-8266
(310) 675-8760
Mailing address
4000 W 139TH ST, HAWTHORNE, CA 90250-7304
(310) 739-3585
(310) 377-9508
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Enumeration date
05/17/2007
Last updated
08/22/2020
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