- Enrollment id
- O20070720000700
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1649328824
- Multiple npi flag
- N
- Ccn
- 148008
- Associate id
- 1153422191
- Organization name
- ULTRA CARE HOME HEALTH, INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2250 E DEVON AVE
- Address line 2
- STE 210
- City
- DES PLAINES
- State
- IL
- Zip code
- 600184511