Provider Demographics
NPI:1376555235
Name:ULTIMATE CARE HOSPICE,INC.
Entity Type:Organization
Organization Name:ULTIMATE CARE HOSPICE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:PICARDO
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:951-415-3311
Mailing Address - Street 1:2325 KUEHNER DR STE 129
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3978
Mailing Address - Country:US
Mailing Address - Phone:805-306-0238
Mailing Address - Fax:805-306-1575
Practice Address - Street 1:2325 KUEHNER DR STE 129
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3978
Practice Address - Country:US
Practice Address - Phone:805-306-0238
Practice Address - Fax:805-306-1575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based