Provider Demographics
NPI:1356332159
Name:ULTIMATE CARE PLUS HOME HEALTH
Entity Type:Organization
Organization Name:ULTIMATE CARE PLUS HOME HEALTH
Other - Org Name:AS' LIEF HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR DPCS
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLEANS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-999-2505
Mailing Address - Street 1:4138 EAGLE ROCK BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-4442
Mailing Address - Country:US
Mailing Address - Phone:323-999-2505
Mailing Address - Fax:323-999-2507
Practice Address - Street 1:4138 EAGLE ROCK BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-4442
Practice Address - Country:US
Practice Address - Phone:323-999-2505
Practice Address - Fax:323-999-2507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA557775Medicare ID - Type UnspecifiedHOME HEALTH AGENCY