Provider Demographics
NPI:1407804016
Name:THE ULTIMATE HOME CARE, INC
Entity Type:Organization
Organization Name:THE ULTIMATE HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULYSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALENSIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:328-609-6068
Mailing Address - Street 1:440 BENMAR DR STE 3350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3124
Mailing Address - Country:US
Mailing Address - Phone:281-741-4660
Mailing Address - Fax:281-741-4729
Practice Address - Street 1:440 BENMAR DR STE 3350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3124
Practice Address - Country:US
Practice Address - Phone:281-741-4660
Practice Address - Fax:281-741-4729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX006380251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000105700Medicaid
TX000105700Medicaid
TX172384301Medicaid
TX673167Medicare ID - Type UnspecifiedHOME HEALTH AGENCY
TX000105700Medicaid