- Enrollment id
- O20050330000704
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1144586991
- Multiple npi flag
- N
- Ccn
- 677999
- Associate id
- 3678529807
- Organization name
- UC ULTIMATE THERAPY SERVICES INC
- Doing business as name
- ULTIMATE THERAPY SERVICES
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10103 FONDREN RD
- Address line 2
- STE 330
- City
- HOUSTON
- State
- TX
- Zip code
- 770964658