- Enrollment id
- O20240520003158
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1407509508
- Multiple npi flag
- N
- Ccn
- 757878
- Associate id
- 0143662379
- Organization name
- ULTRA HEALTH SERVICES, INC.
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12501 CHANDLER BLVD
- Address line 2
- STE 206
- City
- VALLEY VILLAGE
- State
- CA
- Zip code
- 916071946