Provider Demographics
NPI:1538397567
Name:IBHA HOME CARE SOLUTIONS
Entity type:Organization
Organization Name:IBHA HOME CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TARAS
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLUM
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:702-235-5650
Mailing Address - Street 1:2016 E DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2298
Mailing Address - Country:US
Mailing Address - Phone:602-795-8336
Mailing Address - Fax:619-374-7150
Practice Address - Street 1:2016 E DANBURY RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2298
Practice Address - Country:US
Practice Address - Phone:602-795-8336
Practice Address - Fax:619-374-7150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-3341322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children