Ideal Healthcare Staff Providers

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

SRAS99897664 Issued in CA

Legal business name

IDEAL HEALTHCARE STAFF PROVIDERS

Practice address

3986 Westside Ave
Suite B
Los Angeles, CA 90008-2630

Phone

(213) 603-1789

Fax

(323) 292-3529

NPI assigned

Oct 20, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Victor Okechukwu Ahaiwe, LVN, BS

Title

Ceo

Phone

(213) 603-1789

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1194035428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3986 WESTSIDE AVE",
            "address_2": "SUITE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082630",
            "telephone_number": "213-603-1789",
            "fax_number": "323-292-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3986 WESTSIDE AVE",
            "address_2": "SUITE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082630",
            "telephone_number": "213-603-1789",
            "fax_number": "323-292-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL HEALTHCARE STAFF PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "AHAIWE",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "OKECHUKWU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-603-1789",
        "authorized_official_credential": "LVN, BS"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "SRAS99897664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Los Angeles, CA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.