Provider Demographics
NPI:1831460856
Name:IDEAL ALTERNATIVE SUPPORT
Entity type:Organization
Organization Name:IDEAL ALTERNATIVE SUPPORT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXCUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IMMACULATA
Authorized Official - Middle Name:
Authorized Official - Last Name:INYANG
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:214-607-3650
Mailing Address - Street 1:100 BEECHWOOD PL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-8906
Mailing Address - Country:US
Mailing Address - Phone:214-607-3650
Mailing Address - Fax:
Practice Address - Street 1:100 BEECHWOOD PL
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8906
Practice Address - Country:US
Practice Address - Phone:214-607-3650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child