- Enrollment id
- O20230714000982
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1114679578
- Multiple npi flag
- N
- Ccn
- 757616
- Associate id
- 4183084718
- Organization name
- ULTIMATE CARE HOME HEALTH SERVICES, INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 18345 VENTURA BLVD
- Address line 2
- STE 318
- City
- TARZANA
- State
- CA
- Zip code
- 913564242