Ideal Provider, Llc

LBN: Ideal Provider, Llc
Ideal Provider, Llc is an health care organization with primary practice located at 8869 Centre St # 3 , Southaven MS 38671-1725. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Hospitals / Long Term Care Hospital, Respite Care Facility / Respite Care. Respite Care Facility / Respite Care is the primary health care specialty. Ideal Provider, Llc can be contacted via phone (662) 342-7023, or through Edmunds, Ngozi via phone (662) 342-7023.

Contact Information

Primary practice address
8869 Centre St # 3 Southaven MS 38671-1725
Phone: (662) 342-7023
Fax: (662) 342-7089
Website:
Map and Directions
Authorized official contact:
Name: Edmunds, Ngozi
Phone: (662) 342-7023

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X
Hospitals / Long Term Care Hospital 282E00000X
Respite Care Facility / Respite Care 385H00000X

Profile Details

NPI number 1013141357
LBN Legal business name Ideal Provider, Llc
DBA Doing business as
Authorized official Edmunds, Ngozi
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2009
Last updated May 13th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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